22352597
Description
Mind Map by Samah Kannas, updated more than 1 year ago
|
Created by Samah Kannas
about 4 years ago
|
|
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
- resolved URI
- Petechiae \ Purpura in
any place of the body
- Medical History
- A
- A
- Family History
- A
- A
- Diet , Alcohol and smoking
- Healthy
- Healthy
- History of travelling
- A
- A
- Examination
- Notice & classify
- Petechiae
- Purpura
- Ecchymosis
- Petechiae
- Palpate liver & spleen for
hepatomegaly \ splenomegaly
- Investigations
- CBC
- very low platelets count
- very low platelets count
- Peripheral Blood smear
- To asses the morphology of the
platelets & other blood cells
- increased size
- increased size
- To asses the morphology of the
platelets & other blood cells
- PT
- Evaluates the clotting factors
in the intrinsic pathway
- Normal
- Normal
- Evaluates the clotting factors
in the intrinsic pathway
- PTT
- Evaluates the clotting factors
of the extrinsic pathway
- Normal
- Normal
- Evaluates the clotting factors
of the extrinsic pathway
- BM Aspiration and
- for confirmation of the diagnosis
and excluding malignancies
- High megakaryocytes
- High megakaryocytes
- for confirmation of the diagnosis
and excluding malignancies
- Bleeding Time
- Prolonged
- Prolonged
- Platelet Function assay
- Done to investigate and
clotting factor deficiency
- Done to investigate and
clotting factor deficiency
- +
- CBC
- History and Examination suggest those DD ,
investigations are needed to diagnose
- II
V
- Bleeding Disorders
- Vessel Wall Abnormalities
- Vit C deficiency
- systemic amyloidosis
- vasculitides
- Vit C deficiency
- Abnormal Clotting Factors
- Congenital
- hemophilia (A/B)
- --
- Excluded by age
- Excluded by age
- --
- hemophilia (A/B)
- Acquired
- liver disease
- DIC
- liver disease
- Congenital
- Abnormal platelets
- Defective Platelet Function
- Bernard-Soulier syndrome
- 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
- tissue repair happen
- a clot is formed and prolonged
bleeding is prevented
- Responsible for the secondary coagulation
- (primary coagulation )
- They initiate the coagulation
process and for the platelet plug in
case of injury to the blood vessel
- Thrombopoiesis
- Their functions
- tiny cells , less than 1% of blood.
concentration is 150,000-450,000 \ nL. No
nucleus but they have a mitochondria
- How they are formed
- Reduced Platelets count
- ITP (Idiopathic Thrombocytepenic Purpura)
- Immune destruction of the
antibody coated platelets
- can be classified
- Acute
- In children after viral infection
- In children after viral infection
- Chronic
- women between 20-40
- women between 20-40
- Acute
- 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
- Increased platelets counts
confirmed the diagnosis
- very effective treament
- +
- IVIG
- surgical
- Splenectomy
- Splenectomy
- Pharmacological
- Corticosteroids
- Reduce destruction
- Reduce destruction
- Thrombopoietin receptor agonists
- Antiplasmin agents
- Megakaryocytes growth factors
- incease poduction
- incease poduction
- Corticosteroids
- Immunological
- Risk factors
- gender \ female
- SLE
- Drugs
- infections
- pregnancy
- gender \ female
- Immune destruction of the
antibody coated platelets
- Acute Immune Thrombocytopenia
- DRUG-Induced Thrombocytopenia
- Heparin
- --
- No history for drug use
- No history for drug use
- Heparin
- HIV Associated Thrombocytopenia
- ITP (Idiopathic Thrombocytepenic Purpura)
- Defective Platelet Function
- Infection
- viral
- bacterial
- parasitic
- --
- No IV drugs \ travelling history
- No IV drugs \ travelling history
- viral
- Vessel Wall Abnormalities
- Cancer
- --
- No weight loss ,
investigations were clear
- No weight loss ,
investigations were clear
- --
- Allergic reaction
- --
- No chemical exposure ,
no allergy symp
- No chemical exposure ,
no allergy symp
- --
- II
V
- Examin the lymph nodes
- Normal
- Normal
- Notice & classify
- Exposure to chemicals
- A
- A
- Ask if there is pain anywhere
- History
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