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Question 11#

The first step in treating a 70-kg patient with a platelet count of 12,000 due to heparin-induced thrombocytopenia is:

A. Anticoagulation
B. Transfusion of four units of platelets
C. Transfusion of eight units of platelets
D. Transfusion of 12 units of platelets

Correct Answer is D

Comment:

Thrombocytopenia may require platelet transfusion for a platelet count less than 20,000/mL when invasive procedures are performed, or when platelet counts are low and ongoing bleeding from raw surface areas persists. One unit of platelets will increase the platelet count by 5000 to 7500/mL in adults. It is important to delineate the cause of the low platelet count. Usually there is a self-limiting or reversible condition such as sepsis. Rarely, it is due to heparin-induced thrombocytopenia I and II. Complications of heparin-induced thrombocytopenia II can be serious because of the diffuse thrombogenic nature of the disorder. Simple precautions to limit this hypercoagulable state include saline solution flushes instead of heparin solutions and limiting the use of heparin -coated catheters. The treatment is anticoagulation with synthetic agents such as argatroban.