Fichas
Immune Thrombocytopenic Purpura (ITP)
Fichas del conjunto (14)
- 1ITP can be ____ or _____acute, chronic
- 2T/F: Acute ITP is typically seen in childrenTrue. Peak age is 2-6 years. 20-40 years for chronic ITP.
- 3T/F: Gender plays a role in acute ITPFalse. There is no gender preference in acute ITP. There is for chronic ITP though. F > M (3:1)
- 4History of recent infection in acute and chronic ITPCommon in acute, rare in chronic
- 5Onset of bleed in acute and chronic ITPAbrupt in acute, gradual in chronic
- 6Duration of condition in acute and chronic ITPUsually weeks for acute and months to years for chronic
- 7Spontaneous remissions in acute and chronic ITP>80% in acute and uncommon in chronic
- 8T/F: Chronic ITP is the most common cause of isolated thrombocytopeniaTrue
- 9How is ITP diagnosed?Diagnosis of exclusion (chronic ITP): isolated thrombocytopenia and absence of underlying cause.
- 10What is the pathophysiology of ITP?- Acquired immune-mediated disorder
- Anti-platelet antibodies bind to platelet surface. This causes splenic destruction and clearance
- Leads to impaired platelet production - 11What is the clinical presentation of ITP?- Can present with no symptoms
- Minimal bruising to a serious bleed - 12What investigations would you order for ITP? Include expected results for ITP.- CBC and retic count: thrombocytopenia
- PT and aPTT: normal (this is a primary hemostatic problem)
- Blood smear: decreased platelets, giant platelets
- Test for HIV and HCV (these are risk factors for ITP)
- Bone marrow aspirate and biopsy: increased number of megakaryocytes (important in pts > 60yo to R/O myelodysplasia) - 13Outline the emergency management of ITP- Stop any drugs that are reducing platelet numbers or function, control BP, minimize trauma
- Corticosteroids: prednisone
- Antifibrinolytic: tranexamic acid
- IVIG
- Platelet transfusion: for life threatening-bleed
- Emergency splenectomy - 14Outline the non-urgent management of ITP- In general platelet transfusions DO NOT work
- First line: corticosteroids, IVIG, anti-D (for Rh+, non-splenectomized patients)
- Second line: immunosuppresants (azathioprine, cyclophosphamide), rituximab (B cell immunosuppresant), danazol or vincristine, splenectomy
Información
- Descripción
- Fichas sobre Immune Thrombocytopenic Purpura (ITP), creado por indysahota el 03/10/2013.
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- indysahota
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