The Intern At Work: Internal Medicine 5. A Paucity of Platelets - Thrombocytopenia
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Jul 1, 2018 Exploring platelets and thrombocytopenia, the episode covers their role in preventing bleeding, causes of thrombocytopenia, diagnosis, and management of ITP, TTP, and HIT to assist in patient discussions on the ward.
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Platelet Physiology Primer
- Platelets are not cells but fragments from megakaryocytes, regulated by thrombopoietin (TPO) from the liver.
- They form an initial platelet plug at injury sites to stop bleeding before coagulation stabilizes the clot.
Band-aid Analogy for Causes
- Thrombocytopenia causes mirror band-aid inventory issues: decreased production, increased destruction, or sequestration.
- Understanding this analogy guides clinicians to the root cause: bone marrow, consumption, or spleen involvement.
History and Stability Check
- Always assess patient stability first: vitals, GCS, ABCs, and look for active bleeding.
- In history, ask about autoimmune diseases, recent meds, infections, alcohol use, and symptoms like mucocutaneous bleeding and constitutional signs.