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22352597
Sana's rash & bruising
Descripción
Mapa Mental sobre Sana's rash & bruising, creado por Samah Kannas el 27/04/2020.
Mapa Mental por
Samah Kannas
, actualizado hace más de 1 año
Más
Menos
Creado por
Samah Kannas
hace alrededor de 4 años
2
0
0
Resumen del Recurso
Sana's rash & bruising
28 YO woman, with non itchy & non painful rash on her shins + easy bruising for the last 3 weeks
History
Ask if there is pain anywhere
Recent bleeding ?
Petechiae \ Purpura in any place of the body
Gum bleeding
epistaxis
Menorrhagia
History of infection
resolved URI
Medical History
A
Family History
A
Diet , Alcohol and smoking
Healthy
History of travelling
A
Examination
Notice & classify
Petechiae
Purpura
Ecchymosis
Palpate liver & spleen for hepatomegaly \ splenomegaly
Investigations
CBC
very low platelets count
Peripheral Blood smear
To asses the morphology of the platelets & other blood cells
increased size
PT
Evaluates the clotting factors in the intrinsic pathway
Normal
PTT
Evaluates the clotting factors of the extrinsic pathway
Normal
BM Aspiration and
for confirmation of the diagnosis and excluding malignancies
High megakaryocytes
Bleeding Time
Prolonged
Platelet Function assay
Done to investigate and clotting factor deficiency
+
History and Examination suggest those DD , investigations are needed to diagnose
II V
Bleeding Disorders
Vessel Wall Abnormalities
Vit C deficiency
systemic amyloidosis
vasculitides
Abnormal Clotting Factors
Congenital
hemophilia (A/B)
--
Excluded by age
Acquired
liver disease
DIC
Abnormal platelets
Defective Platelet Function
Bernard-Soulier syndrome
What are platelets
How they are formed
Their functions
They initiate the coagulation process and for the platelet plug in case of injury to the blood vessel
(primary coagulation )
<=
Responsible for the secondary coagulation
a clot is formed and prolonged bleeding is prevented
tissue repair happen
Thrombopoiesis
tiny cells , less than 1% of blood. concentration is 150,000-450,000 \ nL. No nucleus but they have a mitochondria
Reduced Platelets count
ITP (Idiopathic Thrombocytepenic Purpura)
Immune destruction of the antibody coated platelets
can be classified
Acute
In children after viral infection
Chronic
women between 20-40
Spleen is site of anti-platelet antibody production & major site of destruction of the IgG coated platelets.
+
Management
Immunological
IVIG
+
Increased platelets counts confirmed the diagnosis
very effective treament
surgical
Splenectomy
Pharmacological
Corticosteroids
Reduce destruction
Thrombopoietin receptor agonists
Antiplasmin agents
Megakaryocytes growth factors
incease poduction
Risk factors
gender \ female
SLE
Drugs
infections
pregnancy
Acute Immune Thrombocytopenia
DRUG-Induced Thrombocytopenia
Heparin
--
No history for drug use
HIV Associated Thrombocytopenia
Infection
viral
bacterial
parasitic
--
No IV drugs \ travelling history
Cancer
--
No weight loss , investigations were clear
Allergic reaction
--
No chemical exposure , no allergy symp
Examin the lymph nodes
Normal
Exposure to chemicals
A
Recursos multimedia adjuntos
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