SOMOS Annual meeting
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presents
Wheeless' Textbook of Orthopaedics

Thrombocytopenia/Platlet Dysfunction



- See:
    - Bld Prod Menu:
    - Platlet Transfusion

- Discussion:
  - manifestations:
          - vessel or platlet abnormalities:
          - these present with petechiae, purpura, or easy bruising;
          - bleeding characteristically occurs superficially (bleeding from mucus membranes or from IV sites);
          - bleeding from scury shows perifolicular hemorrhages, gingival bleeding, and intramuscular hematomas;
    - causes: 
          - dilutional thrombocytopenia after massive RBC transfusion or IV fluid therapy;
                  - treat with platlet transfusions as needed;
                  - transfuse 8 units of platlets for every 10-12 units of pRBC's transfused;
          - von willebrand's dz:
                  - treat with cryoprecipitate or DDAVP;
          - acquired platlet dysfunction:
                  - uremia: w/ uremia try conjugated estrogens;
          - medications:
                  - heparins (see heparin induced thrombocytopenia)
                  - quinine
                  - platlet inhibitors
                  - antibiotics: zyvox, sulfa agents (septra), rifampin, vancomycin
                  - sedatives and anticonvulsants
                  - cimetidine




 - Management of Bleeding secondary to Platlet Abnormalities:
    - serious bleeding complicatios:
         - platlets (6-8 units at a time);
         - one unit of platlets will increase platlet count by 1000;
         - check 1hr post platlet count;







 References:

 









Original Text by Clifford R. Wheeless, III, MD.

Last updated by Clifford R. Wheeless, III, MD on Tuesday, May 13, 2008 7:06 pm