250453
Descripción
Fichas por indysahota, actualizado hace más de 1 año
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Creado por indysahota
hace casi 11 años
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| Pregunta | Respuesta |
| ITP can be ____ or _____ | acute, chronic |
| T/F: Acute ITP is typically seen in children | True. Peak age is 2-6 years. 20-40 years for chronic ITP. |
| T/F: Gender plays a role in acute ITP | False. There is no gender preference in acute ITP. There is for chronic ITP though. F > M (3:1) |
| History of recent infection in acute and chronic ITP | Common in acute, rare in chronic |
| Onset of bleed in acute and chronic ITP | Abrupt in acute, gradual in chronic |
| Duration of condition in acute and chronic ITP | Usually weeks for acute and months to years for chronic |
| Spontaneous remissions in acute and chronic ITP | >80% in acute and uncommon in chronic |
| T/F: Chronic ITP is the most common cause of isolated thrombocytopenia | True |
| How is ITP diagnosed? | Diagnosis of exclusion (chronic ITP): isolated thrombocytopenia and absence of underlying cause. |
| What is the pathophysiology of ITP? | - Acquired immune-mediated disorder - Anti-platelet antibodies bind to platelet surface. This causes splenic destruction and clearance - Leads to impaired platelet production |
| What is the clinical presentation of ITP? | - Can present with no symptoms - Minimal bruising to a serious bleed |
| What investigations would you order for ITP? Include expected results for ITP. | - CBC and retic count: thrombocytopenia - PT and aPTT: normal (this is a primary hemostatic problem) - Blood smear: decreased platelets, giant platelets - Test for HIV and HCV (these are risk factors for ITP) - Bone marrow aspirate and biopsy: increased number of megakaryocytes (important in pts > 60yo to R/O myelodysplasia) |
| Outline the emergency management of ITP | - Stop any drugs that are reducing platelet numbers or function, control BP, minimize trauma - Corticosteroids: prednisone - Antifibrinolytic: tranexamic acid - IVIG - Platelet transfusion: for life threatening-bleed - Emergency splenectomy |
| Outline the non-urgent management of ITP | - In general platelet transfusions DO NOT work - First line: corticosteroids, IVIG, anti-D (for Rh+, non-splenectomized patients) - Second line: immunosuppresants (azathioprine, cyclophosphamide), rituximab (B cell immunosuppresant), danazol or vincristine, splenectomy |
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