ITP

Question 1

Target of antibodies on platelet surface in ITP

Answer 1

-platelet membrane glycoproteins IIb-IIIa or Ib-IX
- immunoglobulin G (IgG) type.

Question 2

causes of ITP

Answer 2

• idiopathic most commonly
• viruses
• vaccinations
• medications
• CLL
• VWF type 2B

Question 3

Von willebrand subtype that can cause ITP

Answer 3

2B

Question 4

Gender predominance of ITP

Answer 4

Females (3:1, autoimmune…)

Question 5

fostamatinib mechanism

Answer 5

SYK inhibition

Question 6

Other SE’s of IVIG

Answer 6

Headache
Aseptic meningitis
Thrombosis
*FDA black box warning for renal failure

Question 7

Rituxan SE’s

Answer 7

• serum sickness
• infusion reactions
• infection
• persistent hypogammaglobulinemia

Question 8

First line therapy for ITP in pregnancy

Answer 8

steroids +/- IVIG

Question 9

Eltrombopag SE’s to know

Answer 9

• hepatotoxicity
• VTE

Question 10

Refractory ITP in pregnancy mgmt options

Answer 10

• anti-D immunoglobulin
• azathioprine
• splenectomy can be done
  *TPO agonist safety data is limited but emerging information suggests they are safe

Question 11

Neonatal alloimmune thrombocytopenia management

Answer 11

• transfuse HPA-1a antigen negative platelets

Question 12

ITP smear

Answer 12

Large platelets

Question 13

MEchanism of steroids in ITP

Answer 13

• decreased phagocytosis of antibody-coated platelet by phagocytes in both the spleen and liver

Question 14

Mechanism of IVIG in ITP

Answer 14

Fc receptor blockade

Question 15

Sequela of splenectomy for ITP

Answer 15

*VTE
Increased infection risk