USMLE
2016-12-13 07:30:52 0 举报AI智能生成
Hemostasis
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Primary
Process
Vasoconstriction
Platelet Adhesion
PLT Degranulation
PLT Aggregation
Disorders
Abnormalities in PLT
Quantitative
Immune Thrombocytopenic Purpura(ITP)
Type
Acute
Children
Weeks after viral infection
Self-limited, resolving within weeks
Chronic
Adults
Women of childbearing age
May secondary of SLE
IgG produced by plasma cells in the spleen
Treatment
Corticosteroid
Children respond well, relapse in adults
IVIG
Raise PLT count, short-lived
Splenectomy
Microangiopathic Hemolytic Anemia
Disease
Thrombotic Thrombocytopenic Purpura(TTP)
Decreased ADAMTS13
Hemolytic Uremic Syndrome(HUS)
E coli O157:H7 dysentery
Clinical Findings
Skin and Mucosal Bleeding
Fever
Renal Insufficiency(HUS)
Thrombi involve vessels of kidney
CNS Abnormalities(TTP)
Thrombi involve vessels of CNS
Lab Findings
Prolonged bleeding time
Normal PT/PTT
Anemia with schistocytes
Increased Megakaryocytes on bone marrow biopsy
Treatment
Plasmapheresis
Corticosteroids(TTP esp)
Qualitative
Bernard-Soulier Syndrome
Genetic GPIb deficiency
Thrombocytopenia with enlarged PLT
PLT adhesion impaired
Glanzmann Thrombasthenia
Genetic GPIIb/IIIa deficiency
Secondary
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