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22 Cards in this Set
- Front
- Back
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pseudothrombocytopenia
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lab manifestation
due to antibody activation by EDTA-Calcium in the lab reagent -> platelet clump need to rerun test with citrate |
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immune thrombocytopenia diagnosis
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disease associated
IgG against P1-A1 antigen adequate marrow magakaryocytes, but low platelet platets are large and grandulated |
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post transfusion purpura
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rare
thrombocytopenia lasting 10-60 days onset is 5-10 after transfusion of blood often in women - pregnancy alloimmuinizaiton against P1-A1 antigen - effected patients dont have the antigen so make antibodies to it |
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treatment of post transfusion purpura
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gamma globulin (IVIg)
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drugs causing immune thrombocytopenia
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sulfa
gold heparin quinidine |
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heparin induced thrombocytopenia
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onset 7-14 days post heparin exposure
factor 4 IgG thrombosis AND hemorrhage if have HIT, stop all heparin even LMWH, give ACTIVE therapy - lepirudin etc...NO WARFARIN |
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when do you give lepirudin vs agatroban
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lepiruden cannot be used in patients with renal problems
agatroban cannot be used in patients with liver problems |
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Quinine induced thrombocytopenia
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severe thrombocytopenia < 10000 platelets
thrombosis not a problem, massive bleeding antibody to hapten/glycoproein1b |
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general treatment for drug induced thrombocytopenia
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remove drug
IVIg |
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Thrombotic Thrombocytopenic Purpura 5 main characteristics
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thrombocytopenia
microangiopathic hemolytic anemia (inc LDH, see schizocytes) neurologic dysfunction renal dysfunction fever |
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hemolyric uremic syndrome
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thrombocytopenia
hemolytic anemia renal failure causes: mostly infection, ecoli O157;H7 primarily of infant onset |
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thrombotic thrombocytopenic purpura
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IgG antibodies against ADAMTS13
need ADAMTS13 to break vWF into small fragments get clots -> mechanical damage to RBC fatal if not treatment treat with plasma infusion/exchange IVIg no effect |
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Thrombocytopenia of Pregnancy and preclampsia
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HELLP syndrome
(H)emolysis (E)levated (L)iver enzyme (L)ow (P)latetlet count treat: deliver child, will resolve |
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T/F thrombocytopenia is physiologic in pregnancy
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true
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Thrombocytopenia associated hemophilia
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treat like chronic ITP with steroid, IVIg splenectomy
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Thrombocytopenia associated with HIV
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marrow megkaryocytes supressed
immune complex antiplatlet antibodies |
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Hypersplenism
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normal spleen 1/3 platelets sequester
in hyperspleen 90% sequester see palpable spleen platelets slightly low bone marrow normal megakaryocyte normal |
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gray platelet syndrome
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alpha storage pool deficiency
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dense granule deficiency
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delta storage pool deficiency
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glanzmann Thromboasthenia
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GP IIb/IIIa deficiency
looks like platelet type problem treat with platelets |
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Bernard soulier
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deficient GP Ib
lack vWF factor platelet binding - no adhesion platelet type bleeding pattern treat with platelet transfusion |
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thrombocytosis treatment
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don't use antiplatelet agents unless there is a myeloproliferative disorder
preop platelets greater than 1 million need reduction of platelet |
