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40 Cards in this Set

  • Front
  • Back
1. ITP?
a. A condition of increased platelet destruction by circulating antiplatelet antibodies, most frequently antiglycoprotein IIb/IIIa.
b. Likely triggered by a preceding viral illness.
c. Equal gender distribution.
2. Presentation of ITP?
a. Young children present w/acute onset of petechiae and purpura and a hx of a viral illness 1-4 weeks previously.
b. Bleeding from the gingivae and other mucous membranes may occur.
3. PE findings with ITP?
a. Petechiae and purpura, especially in trauma areas.
b. If significant lymphadenopathy or organomegaly is found, other causes for thrombocytopenia are considered.
4. Next step in evaluation of suspected ITP?
a. Evaluation of peripheral blood smear.
b. Generally, bone marrow eval aspiration is unnecessary.
5. When may bone marrow eval aid in proper diagnosis?
a. If the peripheral blood smear is concerning, the WBC count is abnormal, or adenopathy or organomegaly is present.
b. Bone marrow eval would demonstrate an increased number of megakaryocytes in ITP.
6. Most common cause of thrombocytopenia in a well child aged 2-5?
a. Acute ITP.
7. Lab findings in ITP?
a. Thrombocytopenia with normal or increased platelet size.
b. WBC and Hb are normal (unless excessive bleeding has occurred).
c. Normal PT and PTT.
8. Peripheral blood smear w/ITP?
a. May reveal eosinophilia or atypical lymphocytes
b. Immature WBCs and abnormal red cell morphology are absent.
9. Prognosis of acute ITP?
a. Within 1 month of presentation, more than half of untreated children have complete resolution of their thrombocytopenia and up to another 30% have resolution by 6 months.
10. When is ITP considered chronic?
a. Persistence beyond 6 months.
11. Most serious ITP complication?
a. Intracranial haemorrhage.
b. Occurs in <1% of affected children.
12. Sx of Severe thrombocytopenia (<20,000)?
a. Extensive mucosal bleeding
b. Massive GI bleeds
13. Tx of ITP?
a. Treatment is controversial. Data do not demonstrate improved outcomes.
b. Tx to decrease platelet destruction includes:
1. IV Ig for 1-2 days.
2. IV anti-D therapy
3. or 2-3 week course of systemic steroids.
14. Is Platelet transfusion used for ITP?
a. No, Only for life-threatening bleeds.
15. Tx of ITP for children w/serious complications not responding to other therapies?
a. Splenectomy.
b. After splenectomy, pneumococcal vaccine and pcn prophylaxis are required bc of risk for sepsis.
16. What % of ITP pts have chronic thrombocytopenia (lasting more than 6 months)?
a. 10-20%.
b. Occurs more commonly in older children and females.
17. Drugs which may cause immune-mediated thrombocytopenia?
a. PCNs
b. TMP-SMX
c. Digoxin
d. Quinine/Quinidine
e. Cimetidine
f. Benzos
g. Heparin.
18. Note: The MMR vaccine is associated w/thrombocytopenia and is used cautiously in ITP pts.
18. Note: The MMR vaccine is associated w/thrombocytopenia and is used cautiously in ITP pts.
19. Initial management of ITP?
a. Close observation and protective environment.
20. Classic triad of HUS?
1. Nephropathy
2. Thrombocytopenia
3. Microangiopathic Haemolytic anaemia.
11. Most serious ITP complication?
a. Intracranial haemorrhage.
b. Occurs in <1% of affected children.
12. Sx of Severe thrombocytopenia (<20,000)?
a. Extensive mucosal bleeding
b. Massive GI bleeds
13. Tx of ITP?
a. Treatment is controversial. Data do not demonstrate improved outcomes.
b. Tx to decrease platelet destruction includes:
1. IV Ig for 1-2 days.
2. IV anti-D therapy
3. or 2-3 week course of systemic steroids.
14. Is Platelet transfusion used for ITP?
a. No, Only for life-threatening bleeds.
15. Tx of ITP for children w/serious complications not responding to other therapies?
a. Splenectomy.
b. After splenectomy, pneumococcal vaccine and pcn prophylaxis are required bc of risk for sepsis.
16. What % of ITP pts have chronic thrombocytopenia (lasting more than 6 months)?
a. 10-20%.
b. Occurs more commonly in older children and females.
17. Drugs which may cause immune-mediated thrombocytopenia?
a. PCNs
b. TMP-SMX
c. Digoxin
d. Quinine/Quinidine
e. Cimetidine
f. Benzos
g. Heparin.
18. Note: The MMR vaccine is associated w/thrombocytopenia and is used cautiously in ITP pts.
18. Note: The MMR vaccine is associated w/thrombocytopenia and is used cautiously in ITP pts.
19. Initial management of ITP?
a. Close observation and protective environment.
20. Classic triad of HUS?
1. Nephropathy
2. Thrombocytopenia
3. Microangiopathic Haemolytic anaemia.
a. A prodrome of bloody diarrhoea is common.
21. What is HUS associated w/?
a. E. Coli 0157:H7
b. Shigella
c. Salmonella.
22. How do pts w/HUS present?
a. Pallor
b. Lethargy
c. Decreased urine output
d. Some have hepatosplenomegaly, petechiae, and oedema.
23. HSP pathophys and presentation?
a. A syndrome of small-vessel vasculitis in young children.
b. The syndrome may have:
1. dermatologic (petechial/purpuric rash)
2. Renal (nephritis)
3. GI (abdominal pain, GI bleeding, intussusception! obstruction)
4. Joint involvement (arthritis)
c. Abdominal pain requires careful eval!
24. Lab-findings in HUS?
a. Haemolytic anaemia and thrombocytopenia.
25. Peripheral blood smear for HUS?
a. Helmet cells
b. Burr cells
c. Fragmented RBCs
26. How is acute renal failure in HUS manifested?
a. Haematuria
b. Proteinuria
c. Elevated serum creatinine.
27. Management of HUS?
a. Supportive w/careful monitoring of renal and hematologic parameters.
b. Dialysis may be required.
28. Initial therapy of HSP?
a. Hydration and pain control.
29. What does UA reveal w/renal involvement in HSP?
a. RBCs
b. WBCS
c. Casts
d. Proteins
30. Complete.
30. Complete.