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What is the WBC count? Thrombocytopenia with a high white count suggests leukemia or myeloid metaplasia. Thrombocytopenia with a normal white count suggests idiopathic thrombocytopenic purpura or drug reaction. ... DIAGNOSTIC WORKUP
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Is there a petechial rash? The presence of a petechial rash suggests either a thrombocytopenic purpura, which may be idiopathic or secondary to leukemia, aplastic anemia, collagen disease, or drugs. In addition, petechiae may suggest platelet ... DIAGNOSTIC WORKUP
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Because the differential diagnosis of purpura is very large, begin by determining whether the purpura is palpable or nonpalpable. Subsequent workup is dictated by the history, physical, and review of systems to determine appropriate diagnostic... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Purpura represents leakage of blood from vessels into skin/mucous membranes; thus, it is nonblanching on pressure; petechiae are <3 mm, ecchymosis >3 mm in diameter. Idiopathic thrombocytopenic purpura (ITP) is the most common cause of>... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Thrombocytopenia is defined as a platelet count of <150,000. Mild (100,000–150,000) and moderate (50,000–100,000) thrombocytopenia are rarely associated with significant bleeding. In contrast to the deep muscle and joint bleeds seen with coagulation factor deficiencies,>... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... The mnemonic VINDICATE is very useful to develop a list of causes of thrombocytopenia.
THROMBOCYTOPENIA
V—Vascular should help the recall of DIC.
I—
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... Purpura is the extravasation of red blood cells from the blood vessels into the skin, subcutaneous tissue, or mucous membranes. It’s characterized by discoloration that’s easily visible through the epidermis, usually purplish or brownish red. Purpuric lesions include... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Decreased Production
Primary hematologic disorders
Aplastic anemia
Acute leukemia
Lymphoproliferative
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... Platelet Disorders
Thrombocytopenia
Drugs, especially
Cytotoxic agents
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... The environment contains thousands of pathogenic microorganisms — viruses, bacteria, fungi, and parasites. Ordinarily, we protect ourselves from infectious organisms and other harmful invaders through an elaborate network of... Host defense system ... Antigens ... B lymphocytes ... T lymphocytes ... Macrophages ... Cytokines ... Complement system ... Polymorphonuclear leukocytes ... Immune disorders ... Hypersensitivity disorders ... Type I hypersensitivity (allergic disorders)
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... The most common cause of hemorrhagic disorders, thrombocytopenia is characterized by deficiency of circulating platelets. Because platelets play a vital role in coagulation, this disease poses a serious threat to hemostasis. (See What happens in thrombocytopenia,... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Allergic purpura, a nonthrombocytopenic purpura, is an acute or chronic vascular inflammation affecting the skin, joints, and GI and genitourinary (GU) tracts, in association with allergy symptoms. When allergic purpura primarily affects the GI tract, with accompanying joint pain,... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Idiopathic thrombocytopenic purpura (ITP), thrombocytopenia that results from immunologic platelet destruction, may be acute (postviral thrombocytopenia) or chronic (Werlhof’s disease, purpura hemorrhagica, essential thrombocytopenia, and... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Purpura is the extravasation of red blood cells from the blood vessels into the skin, subcutaneous tissue, or mucous membranes. It’s characterized by discoloration that’s easily visible through the epidermis, usually purplish or brownish red. Purpuric lesions include... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Mark D. Darrow
A low platelet count is usually brought to the attention of the practitioner as the result of an automated complete blood count in an asymptomatic patient (1).
I. Approach. In working through the differential... Pictures
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... John L. Smith
Purpura are the visible extravasation of blood into the skin or mucous membranes. Petechiae are purpura less than 2 mm in diameter and ecchymoses are greater than 1 cm in diameter.
Approach Purpura are a sign of... History ... Physical examination ... Testing ... Diagnostic assessment (4)
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... Differential Overview
Purpura
❑Trauma
❑Senile purpura
❑Drugs
❑Vasculitis
❑... Diagnostic Approach ... Clinical Findings ... Pictures
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... The most common cause of hemorrhagic disorders, thrombocytopenia is characterized by deficiency of circulating platelets. Because platelets play a vital role in coagulation, this disease poses a serious threat to hemostasis.
The... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Allergic purpura, or anaphylactoid purpura, is a type of nonthrombocytopenic purpura. It’s characterized by allergy symptoms and acute or chronic vascular inflammation affecting the skin, joints, or GI or genitourinary (GU) tract. When allergic purpura primarily affects the GI... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Idiopathic thrombocytopenic purpura (ITP), thrombocytopenia that results from immunologic platelet destruction, may be acute (postviral thrombocytopenia) or chronic (Werlhof’s disease, purpura hemorrhagica, essential thrombocytopenia, autoimmune thrombocytopenia)... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Chronic fatigue and immune dysfunction syndrome (CFIDS) — also known as chronic fatigue syndrome, chronic Epstein-Barr virus [EBV], benign myalgic encephalomyelitis, and “Yuppie flu” — is typically... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Purpura is the extravasation of red blood cells from the blood vessels into the skin, subcutaneous tissue, or mucous membranes. It’s characterized by discoloration that’s easily visible through the epidermis, usually purplish or brownish red. Purpuric lesions include... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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...Purpura are macular discolorations that donot blanch or disappear with pressure. They include petechiae (<3mm in diameter) and ecchymoses (larger lesions). Principal Causes of Purpura and Bleeding Lossof vascular integrity Trauma Infection ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Purpura is the extravasation of red blood cells from the blood vessels into the skin, subcutaneous tissue, or mucous membranes. It's characterized by discoloration that's easily visible through the epidermis, usually purplish or brownish red. Purpuric lesions... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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The mnemonic VINDICATE is very useful to develop a list of
causes of thrombocytopenia.
V—Vascular disorders should help
the recall of disseminated intravascular coagulation (DIC).
I—Inflammation.... Pictures
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... Author:
Esther Forrester, MD
What to Do - Make a Decision, Take Action
The overall goal of immunizations is to prevent disease. This revolution in
science began with the invention of the smallpox vaccine by Jenner... Suggested Readings
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... David F. Friedman, MD
Purpura Fulminans - BASICS
Purpura Fulminans - description
Congenital, acquired, or idiopathic condition of rapidly progressive microvascular hemorrhage into the skin ... Purpura Fulminans - DIAGNOSIS ... Purpura Fulminans - TREATMENT ... Purpura Fulminans - FOLLOW UP ... Purpura Fulminans - bibliography ... Purpura Fulminans - CODES ... Purpura Fulminans - FAQ
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