-
TTP: Lab Results, Etiology or Symptoms, Treatment
Labs:
- ↑BT, LD, Retics, Schistocytes
- ↓PLT, HGB, Haptoglobin
Etiology:
- Autoantibodies to ADAMTS-13
- Secondary: Pregnancy, drugs, HIV, Chemo drug, stem cell transplants
Treatment:
Plasma Exchange
-
ITP: : Lab Results, Etiology or Symptoms, Treatment
Labs:
- ↑BT
- ↓PLT - enlarged plt's seen
- Etiology: Unknwon
- Symptoms: Purpura (easy bruising), bleeding gums or nose, heavy menstrual cycle
Treatment:
IVIG or splenectomy for severe cases
-
HIT: Lab Results, Etiology or Symptoms, Treatment
Lab Results:
- Presence of PLT antibody with ELISA.
- ↓PLT
Etiology or Symptoms:
Occurs in patients treated with unfractionated heparin.Low molecular weight Heparin is less likely to cause HIT
Leads to thromboembolic events
Treatment:
Do not transfuse PLT's! May lead to thrombosis.
-
Hemophilia A: VIII
Labs:
- Symptoms:
- Easy bleeding
- Fibrinolysis
- Hemartrosis (in joints)
- Intramuscular bleeds
Treatment;
DDAVP (creates rapid release of vWF & VIII.Plasma or Recombinant F VIII
-
Hemophilia B; IX
Labs:
- Symptoms:
- Anatomic bleeding:
- Fibrinolysis
- in Joints
- Intramuscular bleeds
Treatment:
Usually not needed
-
Hemophilia C: F XI
Labs:
- Symptoms:
- Anatomic bleeding
- Fibrinolysis
- Hemartrosis (in joints)
- Intramuscular bleeds
Treatment: FFP
-
DIC
Labs:
- ↑PT, PTT, TT
- Positive: Dimer & FDP
- ↓ PLT, Fibrinogen, Antithrombin, Prot C&S,
- MAHA seen on Slide
Symptoms:
Seen in OB patients, organ failure, malignancy, sepsis, and traumas.
Starts out as hypercoaguable with occlusive clots. Increased consumption of coag factors leads to a hemorrhagic state. Bleeding site seen at invasion sites.
Treatment:
Resolve underlying condition before treating the DIC
-
Difference between:
DIC & Fibrinolysis
- DIC: Most Coag tests are abnormal
- Schisotocytes on PM
Fib: Coag tests are all normal
-
Anti-thrombin III Deficiency
- Labs:
- ↓AT, Activity assay screening & Antigen activity
Etiology:
Acquired: Liver Dx, nephrotic dx, DIC, newborns
Tx:
Heparin & AT concentrates or plasma
-
Protein C
Coag inhibitor - Inactivates Va & VIIIa.
Increased risk of thrombosis
-
Protein S
coafactor for C
Labs:
- ↑PT, PTT
- ↓TT (may be N)
- FV Abn.
Etiology:
DVT: seen with liver dx, DIC, pregnancy, & Vit K deficiency
Tx: FFP
-
Bernard-Soulier
- ↑MPV, BT,
- ↓PLT (enlarged plt’s seen)
- PLT Agg Studies: No agg with Ristocetin
Symptoms/Etiology:
Excessive Bleeding
-
Glanzmann's Thombasthenia
Labs:
- ↑ PFA, BT
- ↓PLT AGG Studies: ADP, Epinephrine, Collagen & Normal with Ristocetin
- Etiology/Symptoms:
- Increased bleeding - especially after surgery
-
Post Transfusion Purpura
Labs:
- ↑ BT
- ↓Platelets (markedly)
- N PT, PTT
Etiology:
Rare DTR (delayed transfusion reaction). Caused by alloantibodies specific to plt. Antigens. Bleeding from mucus membranes (i.e. gums), petechia.
Treatment:
- IV immunoglobulin
- Corticosteroids
- Plasmapheresis?
-
Factor V Leiden
Labs:
- APC resistance test
- (Modified PTT): mix together: Corrected = FVjQuery110109971755033862721_1507320851663?
Symptoms:
- Recurrent venous thrombosis
- Systemic bleeding
Treatment:
FFP
|
|
