Q 2 Bleeding Disorders: Platelet Disorders

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Questions and Answers

What is thrombocytopenia characterized by?

  • A reduction in platelet number (correct)
  • An increase in platelet production
  • An abnormality in platelet function
  • An increase in platelet number

What is the main mechanism of drug-induced immune thrombocytopenia?

  • Platelet activation by drug-protein complexes
  • Complement-mediated lysis
  • Immune complex-mediated platelet destruction (correct)
  • Direct platelet toxicity by the drug

What is the typical time frame for the onset of thrombocytopenia in people with drug-associated thrombocytopenia?

  • 2-3 days (correct)
  • 24-48 hours
  • 1-2 weeks
  • 7-10 days

What percentage of people treated with heparin develop a mild, transient thrombocytopenia?

<p>50% (C)</p> Signup and view all the answers

What is the primary cause of heparin-induced thrombocytopenia (HIT)?

<p>Immune reaction against platelet factor 4-heparin complex (A)</p> Signup and view all the answers

What is the primary treatment for heparin-induced thrombocytopenia (HIT)?

<p>Immediate discontinuation of heparin therapy (D)</p> Signup and view all the answers

What is the consequence of the immune complexes formed in HIT?

<p>Platelet activation and thrombosis (B)</p> Signup and view all the answers

What is the result of the activation of platelets in HIT?

<p>Prothrombotic platelet particles and induction of TF (C)</p> Signup and view all the answers

What is the primary cause of platelet destruction in primary ITP?

<p>Immune system directly destroying platelets (A)</p> Signup and view all the answers

What is the typical platelet count in ITP?

<p>Less than 100,000 mL (C)</p> Signup and view all the answers

What is the age group with the highest incidence of primary ITP?

<p>Older adults above 60 years (C)</p> Signup and view all the answers

What is the classification of primary ITP based on duration?

<p>Newly diagnosed, persistent, and chronic (A)</p> Signup and view all the answers

What is a common symptom of ITP?

<p>Bruising and bleeding from the gums (B)</p> Signup and view all the answers

What is the site of platelet destruction in ITP?

<p>Spleen (D)</p> Signup and view all the answers

What is the inheritance pattern of the familial form of TTP?

<p>Autosomal recessive (C)</p> Signup and view all the answers

When can the acquired form of TTP occur?

<p>Only in late childhood or adulthood (D)</p> Signup and view all the answers

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Study Notes

Thrombocytopenia

  • Thrombocytopenia is a reduction in platelet number, which can result from: • Decreased platelet production • Increased sequestration of platelets in the spleen • Destruction of platelets by antibodies • Depletion of platelets due to thrombi • Dilution of blood through multiple transfusions • Decreased platelet survival

Drug-Induced Thrombocytopenia

  • Some drugs, such as aspirin, atorvastatin, and some antibiotics, can cause drug-induced immune thrombocytopenia
  • These drugs induce an antigen-antibody response and formation of immune complexes, leading to platelet destruction by complement-mediated lysis
  • Drug-associated thrombocytopenia is characterized by: • Rapid fall in platelet count within 2 to 3 days of resuming a drug or 7 or more days after starting a drug for the first time • Rapid rise in platelet count after the drug is discontinued

Heparin-Induced Thrombocytopenia (HIT)

  • HIT is associated with the anticoagulant drug heparin
  • 50% of people treated with heparin develop a mild, transient thrombocytopenia within 2 to 5 days of starting the drug
  • Approximately 1% to 5% of people treated with heparin experience life-threatening thromboembolic events 1 to 2 weeks after the start of therapy
  • HIT is caused by an immune reaction directed against a complex of heparin and platelet factor 4
  • Treatment of HIT requires the immediate discontinuation of heparin therapy

Immune Thrombocytopenic Purpura (ITP)

  • ITP is an isolated thrombocytopenia with a platelet count of less than 100,000 mL
  • Characterized by: • Purpuric rash • Normal white blood cells • Normal hemoglobin
  • ITP results in platelet antibody formation and excess destruction of platelets
  • Primary ITP: • Affects both children and adults • Highest incidence in people older than 60 years • Classified as: • Newly diagnosed (from diagnosis until 3 months) • Persistent (from diagnosis until 3 to 12 months) • Chronic (from diagnosis until >12 months)
  • Secondary ITP: • Associated with autoimmune disorders and chronic infections such as: • Helicobacter pylori • Hepatitis C virus • Epstein-Barr virus • HIV • Clinical manifestations include: • A history of bruising, bleeding from the gums, epistaxis, melena, and abnormal menstrual bleeding • Splenic enlargement may occur • Condition may be discovered incidentally or as a result of signs of bleeding

Thrombotic Thrombocytopenic Purpura (TTP)

  • Familial form: • Autosomal recessive inheritance • Rare, appearing in infancy and early childhood • Symptoms occur regularly and exacerbate with stress
  • Acquired form: • Not inherited • More common, occurring in late childhood or into adulthood • May be a single occurrence or many occurrences over time

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