Immune thrombocytopenic purpura Flashcards Preview

Hematology, oncology > Immune thrombocytopenic purpura > Flashcards

Flashcards in Immune thrombocytopenic purpura Deck (9)
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1
Q

ITP on peripheral smear

A

Large platelets, no schistocytes

2
Q

Clinical course

A

VARIABLE: some do not require any treatment; others have a spontaneous remission or respond to first-line therapy with glucocorticoids; others continue to have severe thrombocytopenia necessitating additional therapy

3
Q

Physical exam

A

Normal

4
Q

Admission criteria per ASH

A

Platelet count <20K (ASH)

5
Q

Management

A

If severe bleeding → IVIG FIRST
IF bleeding or platelets <30,000/mm3 → decadron 40 mg x 4 days (preferred) or prednisone 0.5-2.0 mg/kg/day (ASH)
IF cutaneous symptoms AND platelets ≥30,000/mm3 → active surveillance

6
Q

Second line therapies for ITP

A

splenectomy, rituximab, or a thrombopoietin receptor agonist (TPO-RA) (no head to head studies)
IF surgical candidate → splenectomy + ensure immunizations
IF nonsurgical candidate → rituximab

7
Q

Steroid dosing for acute treatment

A

decadron 40 mg x 4 days (preferred over pred)

8
Q

Indications for treatment

A

1) bleeding

2) platelet count less than 30K

9
Q

Nplate generic name

A

romiplostim

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