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Flashcards in Disorders of hemostasis Deck (20)
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1

Immune thrombocytopenic purpura- Eti

Idiopathic. Immune mediated destruction of platelets. can be associated with autoimmune disorders- SLE, HIV, Hep C.

2

Immune thrombocytopenic purpura- Sx

Very low platelet count with normal blood cells & smear. Mucocutaneous bleeding- eccymosis, petechiae

3

Immune thrombocytopenic purpura- Dx

Isolated thrombocytopenia- platelet <100,00. Exclude HIV, Hep B &C

4

Immune thrombocytopenic purpura- Tx

Corticosteroids. Platelet transfusion if active bleeding present

5

Thrombotic thrombocytopenic purpura- Eti

Deficiency or antibodies to protease that cleaves VWF- causes platelet adhesion and aggregation. Women, HIV & pregnancy

6

Thrombotic thrombocytopenic purpura- Sx

Thrombocytopenia due to platelets into thrombi in microvasculature, -Microcangiopathic hemolytic anemia
hemolysis, microvascular thrombosis. Pentad: + fever, renal failure & neurologic abn (HA, coma, seizure, delerium).

7

Thrombotic thrombocytopenic purpura- Dx

Anemia, reticulocytosis, normal coagulation studies, elevated creatanine

8

Thrombotic thrombocytopenic purpura- Tx

Plasma exchange to restore platelet count.

9

Hemolytic-uremic syndrome- Eti

Following diarrheal illness. Common in carcinoma- breast, gastric, lung- onset 4-8 weeks after chemo.

10

Hemolytic-uremic syndrome- Sx

Microangiopathic hemolytic anemia, thrombocytopenia plus oliguria, proteinuria and uremia. May be accompanied by renal failure, hypertension & pulmonary edema.

11

Hemolytic-uremic syndrome- Dx

Anemia, elevated serum creatanine, hematuria, proteinuria

12

Hemolytic-uremic syndrome- Tx

Urinary sx- fluid & lytes
Renal involvement- dialysis
Plasma exchange

13

Henoch-Schonlein purpura- Eti

Most common systemic vasculitis in children. IgA mediated disorder that causes bleeding in small vessels.

14

Henoch-Schonlein purpura- Sx

Purpuric skin lesion on lower extremities, arms, trunk & butt,
joint symptoms- ankles & knees
Abd pain

15

Henoch-Schonlein purpura- Dx

Skin biopsy- leukocytoclastic vasculitis with IgA
Kidney biopsy- segemental glomeulonephritis

16

Henoch-Schonlein purpura- Tx

Prednisone- often resolves without treatment

17

Heparin-induced thrombocytopenia- Eti

Thrombocytopenia within 5-10 days of heparin exposure. Decrease in platelet >50%. Approx 3% heparin pts

18

Heparin-induced thrombocytopenia- Sx

Thrombosis, throbocytopenia and prothrombic state. often asymptomatic, bleeding rare.

19

Heparin-induced thrombocytopenia- Dx

>50% decrease in platelets, new onset of throbocytopenia following heparin exposure. ELISA

20

Heparin-induced thrombocytopenia- Tx

Discontinue heparin, RO DVT, platelet inhibitor-Argatroban