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Medicine

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Hematology

Question
13 out of 16
 

The following laboratory determinants is abnormally prolonged in ITP: (AIPG 2011)



A APTT
B Prothrombin time

C Bleeding time
D Clotting time

Ans. C

Bleeding time

Clinical Features

1. In children: Typically presents 2 – 3 weeks after a viral infection with sudden onset of purpura, nasal or oral bleeding.

2. In adults: ITP involves females more commonly and has insidious onset. Symptoms and signs of collagen vascular disorders (like rheumatoid arthritis) may be present. The course is chronic with remissions and relapses.

3. Splenomegaly and bleeding in the joints are not the feature of ITP.

Difference between acute of chrome ITP

Note: In ITP, BT is prolonged but CT is normal.

14. Ans. B.

Immunogenic Thrombocytopenia

Management

1. In children, the disease is usually self – limiting within a few weeks.

2. Drugs therapy a. Prednisolone b. Intravenous immunoglobulin

3. Splenectomy

Extra Edge:

1. Platelet transfusion is not effective because in ITP, thrombocytopenia is caused by immune mediated destruction of platelet.

2. Most common cause of death- cerebral hemorrhage.

Extra Edge: Oprelvekin is recombinant interleukin eleven (IL-11), a thrombopoietic growth factor that directly stimulates the proliferation of hematopoietic stem cells and megakaryocyte progenitor cells, resulting in increased platelet production. It is indicated for the prevention of severe thrombocytopenia and the reduction of the need for platelet transfusions following myelosuppressive chemotherapy. (Ref. Harrison 18th ed. pg. 708)

Recent Advances: (Ref. Hari-18th Pg.-969)

1. Two agents thrombopoietin receptor agonists (TPO receptor agonist,) have shown response in many patients with refractory ITP.

a. Romiplostim (Givensubcutaneously)

b. Eltrombopag (Oral)

2. Rituximab

Hematology Flashcard List

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