Flashcards in Disorders of hemostasis Deck (20)
Immune thrombocytopenic purpura- Eti
Idiopathic. Immune mediated destruction of platelets. can be associated with autoimmune disorders- SLE, HIV, Hep C.
Immune thrombocytopenic purpura- Sx
Very low platelet count with normal blood cells & smear. Mucocutaneous bleeding- eccymosis, petechiae
Immune thrombocytopenic purpura- Dx
Isolated thrombocytopenia- platelet <100,00. Exclude HIV, Hep B &C
Immune thrombocytopenic purpura- Tx
Corticosteroids. Platelet transfusion if active bleeding present
Thrombotic thrombocytopenic purpura- Eti
Deficiency or antibodies to protease that cleaves VWF- causes platelet adhesion and aggregation. Women, HIV & pregnancy
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).
Thrombotic thrombocytopenic purpura- Dx
Anemia, reticulocytosis, normal coagulation studies, elevated creatanine
Thrombotic thrombocytopenic purpura- Tx
Plasma exchange to restore platelet count.
Hemolytic-uremic syndrome- Eti
Following diarrheal illness. Common in carcinoma- breast, gastric, lung- onset 4-8 weeks after chemo.
Hemolytic-uremic syndrome- Sx
Microangiopathic hemolytic anemia, thrombocytopenia plus oliguria, proteinuria and uremia. May be accompanied by renal failure, hypertension & pulmonary edema.
Hemolytic-uremic syndrome- Dx
Anemia, elevated serum creatanine, hematuria, proteinuria
Hemolytic-uremic syndrome- Tx
Urinary sx- fluid & lytes
Renal involvement- dialysis
Henoch-Schonlein purpura- Eti
Most common systemic vasculitis in children. IgA mediated disorder that causes bleeding in small vessels.
Henoch-Schonlein purpura- Sx
Purpuric skin lesion on lower extremities, arms, trunk & butt,
joint symptoms- ankles & knees
Henoch-Schonlein purpura- Dx
Skin biopsy- leukocytoclastic vasculitis with IgA
Kidney biopsy- segemental glomeulonephritis
Henoch-Schonlein purpura- Tx
Prednisone- often resolves without treatment
Heparin-induced thrombocytopenia- Eti
Thrombocytopenia within 5-10 days of heparin exposure. Decrease in platelet >50%. Approx 3% heparin pts
Heparin-induced thrombocytopenia- Sx
Thrombosis, throbocytopenia and prothrombic state. often asymptomatic, bleeding rare.
Heparin-induced thrombocytopenia- Dx
>50% decrease in platelets, new onset of throbocytopenia following heparin exposure. ELISA