Vascular Disorders and Bleeding

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the underlying abnormality in vascular disorders?

Abnormalities in the platelet count

Abnormalities in the hemostatic testing

Abnormalities in the vessels themselves or the perivascular connective tissues (correct)

Abnormalities in the megakaryocytes

What is the characteristic of thrombasthenia?

A disorder of platelet production

A disorder of platelet function (correct)

A disorder of increased platelet destruction

A disorder of blood vessel structure

What is the cause of acquired thrombasthenia?

Viral infections such as HIV

Drugs such as aspirin (correct)

Genetic defect

Bone marrow disorders

What is a cause of thrombocytopenia due to decreased platelet production?

Megaloblastic anemia (C) Signup and view all the answers

What is a cause of immune thrombocytopenia?

Chronic lymphocytic leukemia (D) Signup and view all the answers

What is a symptoms of vascular disorders?

Superficial bleeding (C) Signup and view all the answers

What is the primary consideration for treatment decisions in ITP patients?

Need for concomitant antithrombotic therapy or other medications (D) Signup and view all the answers

What is the recommended treatment approach for asymptomatic ITP patients with a platelet count above 30 × 109/L?

Observation and follow-up of platelet count (C) Signup and view all the answers

Which of the following is a therapeutic option for ITP patients in emergency settings?

Intravenous immunoglobulin (IVIg) (C) Signup and view all the answers

What is a potential side effect of long-term steroid use in ITP patients?

Hypertension (C) Signup and view all the answers

Which of the following medications is a Thrombopoietin receptor agonist (TPO-RA)?

Eltrombopag (D) Signup and view all the answers

What is a potential surgical treatment option for ITP patients?

Splenectomy (B) Signup and view all the answers

What is the primary cause of thrombocytopenia in immune thrombocytopenic purpura?

Impaired thrombopoiesis by antiplatelet antibodies (B) Signup and view all the answers

What is the most common initial manifestation of immune thrombocytopenic purpura?

Mucocutaneous bleeding (B) Signup and view all the answers

Which of the following is a secondary cause of immune thrombocytopenic purpura?

Lupus (A) Signup and view all the answers

What is the goal of immune thrombocytopenic purpura management in adults?

To maintain a hemostatic platelet count while minimizing the toxicity of therapy (C) Signup and view all the answers

What is the risk of fatal bleeding in immune thrombocytopenic purpura?

Greatest in elderly patients with persistent and severe thrombocytopenia (D) Signup and view all the answers

What is a diagnostic test for immune thrombocytopenic purpura?

Direct coombs test (C) Signup and view all the answers

What is a condition that may be associated with thrombocytopenia?

All of the above (D) Signup and view all the answers

What is the definition of primary immune thrombocytopenic purpura?

An autoimmune disorder with isolated thrombocytopenia and no secondary cause (C) Signup and view all the answers

Study Notes

Vascular Disorders

Characterized by easy bruising and spontaneous bleeding from small vessels due to abnormalities in vessels or perivascular connective tissues.
Defects can be acquired (abnormalities in endothelial cell lining) or hereditary (connective tissue supporting vessels).

Symptoms

Superficial bleeding
Hemostatic testing is normal

Platelet Disorders

Thrombasthenia

Hereditary thrombasthenia
Acquired thrombasthenia (caused by drugs like Aspirin)

Thrombocytopenia

Causes:
- Disorders of decreased platelet production (congenital thrombocytopenia, viral infections, megaloblastic anemia, myelosuppressive therapy)
- Disorders of increased platelet destruction (immune thrombocytopenia, associated with SLE, CLL, or lymphoma, infection, or drugs)
- Disorders of increased platelet consumption (disseminated intravascular coagulation, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome)
- Dilutional thrombocytopenia
- Splenic sequestration (portal hypertension)

Immune Thrombocytopenia (ITP)

Defined by low platelet count secondary to accelerated platelet destruction and impaired thrombopoiesis by antiplatelet antibodies
Types:
- Primary ITP (isolated thrombocytopenia, no secondary cause)
- Secondary ITP (associated with SLE, CLL, lymphoma, infection, or drugs)

Diagnosis of ITP

Mucocutaneous bleeding, petechiae, purpura, epistaxis, and gum bleeding
Risk of fatal bleeding greatest in elderly patients with persistent and severe thrombocytopenia
Diagnostic tests: direct coombs test, pregnancy test, serum ferritin, H. Pylori, antinuclear antibodies, and PCR for CMV

Treatment of ITP

Goal: maintain hemostatic platelet count while minimizing toxicity and improving health-related quality of life
Treatment individualized to patient, considering other factors like need for antithrombotic therapy, invasive procedures, or surgery
Asymptomatic patients with platelet counts > 30 × 109/L require no treatment
Symptomatic patients or platelet counts < 30 × 109/L require treatment with:
- Corticosteroids (initial treatment)
- Intravenous immunoglobulin (IVIg) (emergency settings)
- Medical therapies (Rituximab, thrombopoietin receptor agonists, azathioprine, cyclosporine A, danazol, dapsone, mycophenolate mofetil)
- Surgical treatment (splenectomy)

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Learn about vascular disorders, a group of conditions characterized by easy bruising and spontaneous bleeding from small vessels, and their underlying abnormalities.