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    Thrombocytopenia

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    Objective

    Physical exam and history e/o thrombocytopenia may include: petechiae, purpura, oral petechiae, ecchymoses, lymphadenopathy, hypersplenism, bloody diarrhea, fever, s/sx of blood clots if hypercoaguable as in HIT.

    Assessment & Plan (short)

    # Thrombocytopenia
    New thrombocytopenia likely due to ***. Common mechanisms include destruction (TTP, HUS, DIC, HIT, ITP), decreased production (leukemia, myelodysplastic, viral, drugs, ETOH, Vit B12, folate, copper deficiencies), and sequestration/hypersplenism (cirrhosis, heart failure, malignancy, infections). Also considered is pseudothrombocytopenia from clumping, smear can exclude.
    - CBC w/diff
    - HIV, HCV
    - HIT Ab with reflex SRA if c/f HIT, stop all heparin products
    - Smear, coags, fibrinogen, LDH, retics (if c/f BM suppression)
    - Retics, immature platelet fraction (if c/f production problem)
    - Platelet goal > *** (often 10 unless active bleeding then 50, 100 if c/f CNS bleed)
    - Patient consented for blood products
    - Hold DVT prophylaxis for plts < *** (typically 50), otherwise continue as appropriate

    Organ systems
    • Hematology
    Medical field
    • Internal medicine
    Setting
    • Inpatient
    Author
    Eric Lee
    Page info

    Originally created: March 3, 2020 by Eric Lee

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    Number of revisions: [xyz-ips snippet="numrevisions"]

    References
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