L2: Bleeding Disorders - Thrombocytopenia

Question 1

Normal characters of platelets

Answer 1

Question 2

Normal characters of platelets

• Number

Answer 2

150,000 - 400,000/mm3

Question 3

Normal characters of platelets

• Distribution

Answer 3

• ⅓ located in spleen
• ⅔ circulate in the blood stream

Question 4

Normal characters of platelets

• Life Span

Answer 4

7-10 days

Question 5

Normal characters of platelets

• Size

Answer 5

1-4 um (younger platelets are larger)

Question 6

Normal characters of platelets

• Mean Platlet Volume

Answer 6

7.1 FL

Question 7

Normal characters of platelets

• Action

Answer 7

Question 8

Def of Thrombocytopenia

Answer 8

Platelet count <150.000/mm3.

Question 9

Another Name of Thrombocytopenia

Answer 9

Platlet Number Defect

Question 10

Etiology of Thrombocytopenia

Answer 10

Question 11

Etiology of Thrombocytopenia

• Decreased megakaryocytes

Answer 11

Question 12

Etiology of Thrombocytopenia

• Normal or Increased Megakaryocytes

Answer 12

Question 13

Most important investigation in thrombocytopenia —->

Answer 13

Bone marrow examination

Question 14

Def of ITP

Answer 14

Question 15

Incidence of ITP

Answer 15

The most common cause of thrombocytopenic purpura

Question 16

Age in ITP

Answer 16

2-8 Years

Question 17

Sex in ITP

Answer 17

Male = Female

Question 18

Characters of ITP

Answer 18

Question 19

Types of ITP

Answer 19

Question 20

Compare Between Types of ITP

Answer 20

Question 21

Compare Between Acute & Chronc & Persistent ITP in terms of

• Duration
• Age
• Sex
• Season
• PLT Count
• Abs
• Response

Answer 21

Question 22

CP of ITP

Answer 22

Question 23

Value of faucial examination in ITP

Answer 23

Petechial Hge in soft palate usually followed by ICH.

Question 24

ICH in ITP

Answer 24

Question 25

Infantile ITP - Age - Onset - Duration - PLT Count - TTT

Answer 25

Question 26

INVx for **ITP**

Answer 26

Question 27

INVx for **ITP** - Bleeding Time

Answer 27

Prolonged

Question 28

INVx for **ITP** - Clotting Time

Answer 28

Normal

Question 29

INVx for **ITP** - Hiss Test

Answer 29

+ve

Question 30

INVx for **ITP** - Platlet Count

Answer 30

<150.000/ mm3

Question 31

INVx for **ITP** - anti-Platlet Antibodies

Answer 31

+ve in 65% of cases

Question 32

INVx for **ITP** - BM Examination

Answer 32

**Diagnostic test** Megakaryocytes - normal or increased - with smooth surface "no budding" D2 rapid release.

Question 33

TTT of **ITP**

Answer 33

Question 34

TTT of **ITP** - Conservative

Answer 34

- Self-limited - Patient is put under observation for fear of I.C. Hge.

Question 35

TTT of **ITP** - CTS

Answer 35

Question 36

TTT of **ITP** - Immunosuppressive Drugs

Answer 36

Cyclosporine - Cyclophosphamide - Azathioprine

Question 37

TTT of **ITP** - Immunoglobulins

Answer 37

Question 38

TTT of **ITP** - Anti-Rh D

Answer 38

Question 39

TTT of **ITP** - Danazol

Answer 39

Question 40

TTT of **ITP** - Plasmapheresis

Answer 40

For life threatening bleeding for removal of Abs

Question 41

TTT of **ITP** - Blood & Platelet Transfusion

Answer 41

- To compensate blood loss & stop bleeding - Temporary effect "as it will be destructed by anti-platelet Abs".

Question 42

TTT of **ITP** - MonoClonal Antibodies

Answer 42

e.g., Rituximab (anti-CD20)

Question 43

TTT of **ITP** - Thrombopoeitin Analogue

Answer 43

Romiplostim "Nplate"

Question 44

TTT of **ITP** - Eltrombopag

Answer 44

Mainly for chronic patients

Question 45

TTT of **ITP** - Spleenectomy

Answer 45

Question 46

Spleenectomy in **ITP** - Indications

Answer 46

- Severe acute cases (non-responsive to medical treatment). - Chronic cases with bleeding (e.g. menorrhagia).

Question 47

Spleenectomy in **ITP** - Precautions

Answer 47

Question 48

Role of Spleen in ITP

Answer 48