15 Questions
What is the primary mechanism of pediatric Heparin induced Thrombocytopenia (HIT)?
Formation of antibodies against heparin
Which of the following groups is at the highest risk of developing HIT?
Children with prolonged UFH exposure or those receiving larger cumulative doses of UFH
What is the consequence of platelet activation in HIT?
Consequent thrombin production
What is the clinical significance of pediatric Heparin induced Thrombocytopenia (HIT)?
A life-threatening immunological drug reaction
What is the underlying pathophysiology of HIT?
An immune-mediated reaction to heparin
What is the primary consequence of the formation of antibodies against heparin in pediatric HIT?
Platelet activation and thrombin production
Which of the following factors is associated with the highest frequency of HIT in children?
Prolonged UFH exposure
What is the underlying cause of thrombin production in pediatric HIT?
Activation of platelets by antibodies against heparin
What is the significance of prolonged UFH exposure in pediatric HIT?
It is associated with a higher frequency of HIT
What is the primary role of thrombin in pediatric HIT?
Consequent thrombosis
Which laboratory test is most specific for diagnosing pediatric HIT?
Platelet factor 4 (PF4) enzyme-linked immunosorbent assay (ELISA)
What is the primary drug of choice for treating pediatric HIT?
Argatroban
Which of the following laboratory tests is likely to be elevated in a patient with pediatric HIT?
D-dimer
What is the primary reason for avoiding platelet transfusions in pediatric HIT?
Risk of platelet activation
Which of the following medications is contraindicated in pediatric HIT?
Unfractionated heparin (UFH)
Study Notes
Pediatric Heparin Induced Thrombocytopenia (HIT)
- Life-threatening, immunological drug reaction that carries a high risk of morbidity and mortality
- Pathologically, HIT results from the formation of antibodies against heparin, leading to platelet activation and consequent thrombin production
Risk Factors
- Prolonged exposure to Unfractionated Heparin (UFH)
- Larger cumulative doses of UFH
Diagnosis
- Laboratory tests show platelet activation and thrombin production
Management
- Drug treatment is necessary to prevent further complications
Pediatric Heparin Induced Thrombocytopenia (HIT)
- Life-threatening, immunological drug reaction that carries a high risk of morbidity and mortality
- Pathologically, HIT results from the formation of antibodies against heparin, leading to platelet activation and consequent thrombin production
Risk Factors
- Prolonged exposure to Unfractionated Heparin (UFH)
- Larger cumulative doses of UFH
Diagnosis
- Laboratory tests show platelet activation and thrombin production
Management
- Drug treatment is necessary to prevent further complications
Pediatric Heparin Induced Thrombocytopenia (HIT)
- Life-threatening immunological drug reaction with high risk of morbidity and mortality
- Pathologically, HIT results from the formation of antibodies against heparin, leading to platelet activation and consequent thrombin production
Risk Factors
- Prolonged UFH exposure
- Larger cumulative doses of UFH
Diagnosis
- Labs to order:
- Platelet count
- Thrombin levels
- Heparin-induced platelet antibodies (HIPA)
Treatment
- Discontinue heparin therapy
- Administer alternative anticoagulants:
- Direct thrombin inhibitors (DTIs) such as argatroban or lepirudin
- Fondaparinux
- Monitor platelet count and thrombin levels regularly
This quiz covers the causes, diagnosis, and treatment of Heparin-Induced Thrombocytopenia, a life-threatening immunological drug reaction in children.
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