VanGarsee high yield Flashcards
Normal platelet count
150-450 K
Primary hemostasis impaired when platelets below…
75K
Spontaneous bleeding with platelet count of…
50K
Noticeable/clinically significant bleeding with platelet count of…
20K
Life-threatening hemorrhage with platelet count of…
10K
BM failure/infiltration
assoc with anemia and leukopenia
mild changes in other cell lines
acquired aplastic anemia
MDS
Fanconi or dyskeratosis congenita
Cyanotic heart disease
decreased production of megakaryocytic d/t marrow not being fed well
Nutritional deficiencies in thrombocytopenia
Folate, B12 - impair BM production –> pancytopenia
Iron - impairs late stage thormbopoiesis
Acute ITP
isolated thrombocytopenia, otherwise normal blood counts and PBS
Most common thrombocytopenia in well children
Sudden onset of bruising/petechiae or mucocutaneous bleeding
50% after viral illness - 1-2 weeks after
NO systemic sx, no LAD
Acute ITP PBS
platelet morphology
Schistocytes
+direct coombs
Fibrin degradation products and fibrinogen measurements
Treating ITP
no tx alters course
Keep plt count > 20K, if drops use prednisone, IVIG, anti-D immunoglobulin
Rare risk of intracranial hemorrhage
Red flags
Constitutional sx hx of dz assoc with low plts Diet suggestive of Fe, B12, folate def. Exposure to meds assoc with low plts PE findings other than signs of bleeding
TTP vs HUS
both: consumption of plts resulting from endothelial cell injury and vasculitis
TTP: adults, thrombocytopenia and hemolytic anemia
HUS: children, vascular inj from toxins - E.coli; microangiopathic hemolytic anemia, thrombocytopenia, acute renal failure
Chronic ITP
Generally benign, ITP >6 mo
Platelet count range 30-80K
Bruising and occ. petechiae
no contact sports
Tx: splenectomy - but only 60-80% long term response
