Platelet disorders CIS

Question 1

workup for thrombocytopenia

Answer 1

• blood smear or WBC or RBC abnormality- bone marrow disorder
• hypersplenism
• immune mediated, ITP, drug induced

Question 2

pts with thrombocytosis are usually?

Answer 2

asymptomatic

Question 3

pts with essential thrombocytopenia may have?

Answer 3

bleeding, thrombosis, or both

Question 4

petechiae

Answer 4

• pinpoint bleeding

- thrombocytopenia

Question 5

purpura

Answer 5

• larger bleed (confluent petechiae)
• thrombocytopenia
• also seen in coagulopathies and CT dz

Question 6

ecchymosis

Answer 6

• in coagulopathy and trauma

- meds

Question 7

hemarthrosis

Answer 7

• bleeding into a joint

- hemophilia

Question 8

nosebleeds

Answer 8

• coag abnormality
• trauma
• hereditary hemorrhagic telangiectasia
• dry mucous membranes

Question 9

erythromelalgia

Answer 9

• in essential thrombocytopenia
• burning pain- fingers/hands
• responds to baby ASA daily!

Question 10

pseudothrombocytopenia

Answer 10

• seen in CBC drawn in EDTA tube- in vitro clumping

- repeat CBC in heparin or citrate tube

Question 11

in hospitalized pts, what meds can lower platelet count?

Answer 11

• loop diuretics
• H2 blockers
• digoxin
• antibiotics

Question 12

ITP- tx

Answer 12

• if no sx’s- observe

- if sx’s- IVIG, prednisone!!!, rituxmiab

Question 13

bernard soulier syndrome

Answer 13

• giant platelets
• pretty healthy pt, just plt count a little low/normal
• absent aggregation to ristocetin, normal aggregation to ADP, collagen, arachidonic acid, epinephrine