Thrombotic Thrombocytopenic Purpura Treatment Strategies

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What is inferred when a patient presents with bleeding but no anatomical cause can be discovered?

Primary coagulation factor deficiency
Functional impairment of the normal hemostatic process (correct)
Excessive platelet activation
Structural abnormalities in blood vessels

Which disorder is characterized by frequent bleeding episodes primarily from the nose and gastrointestinal tract?

Hereditary hemorrhagic telangiectasia (correct)
Steroid purpura
Henoch-Schonlein syndrome
Ehlers-Danlos syndrome

What is the typical presentation of hemarthrosis?

Bleeding in the joints (correct)
Petechiae all over the body
Intracranial hemorrhage
Characteristic skin bruising

Which condition is associated with abnormal telangiectatic capillaries resulting in bleeding episodes?

Hereditary hemorrhagic telangiectasia (A) Signup and view all the answers

In what percentage of cases do individuals with hereditary hemorrhagic telangiectasia develop pulmonary AVM?

40% (D) Signup and view all the answers

At what age, on average, does epistaxis (nosebleeds) begin in individuals with hereditary hemorrhagic telangiectasia?

>12 years old (B) Signup and view all the answers

Which condition is characterized by the need for vitamin C to synthesize hydroxyproline, an essential constituent of collagen?

Scurvy (B) Signup and view all the answers

Which condition is associated with (+) acute inflammatory reaction with IgA and complement components in capillaries, mesangial tissues, and small arterioles?

Henoch-Schönlein purpura (B) Signup and view all the answers

In which condition can glucocorticoid therapy lead to skin bleeding and easy bruising due to atrophy of supporting connective tissue?

Scurvy (A) Signup and view all the answers

Which disorder involves a platelet count lower than 150,000?

Quantitative disorders (A) Signup and view all the answers

What symptom typically precedes Henoch-Schönlein purpura?

<ul> <li>acute inflammatory reaction with IgA (C)</li> </ul> Signup and view all the answers

Which condition involves vasculitis and increased vascular permeability leading to localized hemorrhage?

Cushing's syndrome (A) Signup and view all the answers

What is the most common non-iatrogenic cause of thrombocytopenia?

Infection-induced thrombocytopenia (C) Signup and view all the answers

What is a key step in evaluating a patient with thrombocytopenia?

Reviewing the peripheral blood smear (B) Signup and view all the answers

What is the role of calcium content in causing pseudothrombocytopenia?

Triggering platelet agglutination (C) Signup and view all the answers

When should a bone marrow examination be recommended in the evaluation of thrombocytopenia?

Urgently needed diagnosis or after unsuccessful less invasive methods (C) Signup and view all the answers

What is the fundamental defect in Glanzmann's thrombasthenia?

Absence of the platelet GpIIbIIIa receptor (D) Signup and view all the answers

Which condition presents with bleeding in skin, mucous membrane, recurrent epistaxis, and GI hemorrhage?

Glanzmann's thrombasthenia (A) Signup and view all the answers

What therapy is successful in refractory or relapsing TTP?

Rituximab (A) Signup and view all the answers

Which condition is almost always due to iron deficiency, inflammation, cancer, or infection?

Reactive thrombocytosis (D) Signup and view all the answers

What is the main reason for initiating plasma exchange in TTP?

To resolve hemolysis signs (A) Signup and view all the answers

Which therapy should only be used as an adjunct to plasma exchange in TTP?

Glucocorticoids (D) Signup and view all the answers

What is a common characteristic of Drug-Induced Thrombocytopenia?

It may occur due to herbal and over-the-counter preparations. (A) Signup and view all the answers

Which drug may cause thrombocytopenia within 24 hours of initial exposure?

Abciximab (B) Signup and view all the answers

How long after the initial exposure to classic drug-dependent antibodies does thrombocytopenia typically occur?

21 days (D) Signup and view all the answers

What is a distinguishing feature of the thrombocytopenia caused by platelet GpIIbIIIa inhibitory drugs like abciximab?

It may occur within 24 hours of initial exposure. (B) Signup and view all the answers

What is a distinguishing characteristic of Heparin-Induced Thrombocytopenia?

It is one of the most prescribed drugs. (B) Signup and view all the answers

Why should all drugs be suspected in a patient with thrombocytopenia without an apparent cause?

Because any drug could potentially be the cause and should be stopped. (D) Signup and view all the answers

Bleeding Without Anatomical Cause

A functional impairment of the normal hemostatic process is inferred when a patient has bleeding but no anatomical cause can be identified.

Hereditary Hemorrhagic Telangiectasia

Hereditary hemorrhagic telangiectasia, a disorder characterized by frequent bleeding episodes, typically affects the nose and gastrointestinal tract.

Hemarthrosis

Hemarthrosis, characterized by bleeding in the joints, is a common consequence of various conditions.

Abnormal Telangiectatic Capillaries

Hereditary hemorrhagic telangiectasia involves abnormal telangiectatic capillaries, these fragile vessels easily rupture, resulting in repeated bleeding episodes.