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Evaluating thrombocytopenia
- Always get blood smear - want to examine for schistocytes to rule out thrombotic thrombocytopenic purpura (TTP)
- Immature platelet fraction - can show if patient is producing platelets at higher rate if it is elevated, hinting more at destructive process than at productive process
If platelets are severely low, consider quinine-induced thrombocytopenia, ask about tonic water ingestion!
Managing immune thrombocytopenic purpura (ITP)
- If concerned for ITP but no active bleeding, hold off on transfusing platelets, even if count is low - platelets will just be destroyed
- If platelets are given in evaluation, always obtain post-transfusion platetet count 1 hour after transfusion - if no response, likely ITP
- No role for IVIG in the absence of significant bleeding
- Steroids are always first-line therapy
- 50 percent of patients relapse during steroid taper
Posted 06/27/17 03:19:29 PM by Iheanacho (Obi) Emeruwa
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Posted 06/27/17 03:24:14 PM by Iheanacho (Obi) Emeruwa
Created by Christopher Kelly
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It is not meant to replace the advice of a health professional.