Heparin-induced thrombocytopenia resident survival guide: Difference between revisions

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==Management==
==Management==
Shown below is an algorithm summarizing the approach to [[heparin induced thrombocytopenia]].
Shown below is an algorithm summarizing the approach to [[heparin induced thrombocytopenia]].
{{familytree/start}}<nowiki>{{familytree | | | | | | | | | Thrombocytopenia (Platelet count <150,000/mm<sup>3</sup> or >50% decrease from highest level before initiation of heparin therapy | | | | | |A01=A01}}
{{familytree/start |summary=Heparin Induced Thrombocytopenia Managment Algorithm.
{{familytree | | | | | | | | | |!| | | | | | | | }}
{{familytree | | | | | | | | | | | | K01 | | | | | | | | | | | | | | | | | | | | | | | | | | |K01='''Thrombocytopenia:'''<br><div style="float: left; text-align: left; line-height: 150% "> ❑ Platelet count <150,000/mm<sup>3</sup> or <br> ❑ Decrease from higest level before initiation of heparin therapy <br> ❑ Making sure patient has received heparin or LMWH in the previous 5- 14 days <br> ❑ After ruling out other causes of thrombocytopenia <br> </div>}} }}
{{familytree | | | | | | | | | Make sure patient: ❑ Is receiving heparin or LMWH in previous 5-14 days Rule out other causes of thrombocytopenia| | | | | |B01=B01}}
{{familytree | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | | | |}}
{{familytree | | |,|-|-|-|-|-|-|^|-|-|-|-|-|-|.| }}
 
{{familytree | | C01 | | | | | | | | | | | |C02|C01=C01|C02=C02}}
{{familytree | | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | | | | | | | | | | | |A01='''Examine the patient'''<br><div style="float: left; text-align: left; line-height: 150% "> ❑ <br>❑ </div>}}
{{familytree | | |!| | | | | | | | | | | | | |!| }}
{{familytree | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | | | |}}
{{familytree | | D01 | | | | | | | | | | | |D02|D01=D01'<br>D01''|D02=D02'<br>D02''}}
{{familytree | | | | | | | | | | | | B01 | | | | | | | | | | | | | | | | | | | | | | | | | | |B01='''Consider alternative diagnosis'''<br><div style="float: left; text-align: left; line-height: 150% "> ❑ <br>❑ </div>}}
{{familytree | | |!| | | | | | | | | |,|-|-|-|+|-|-|-|-|.|}}
{{familytree | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | | | |}}
{{familytree | | E01 | | | | | | | | E02 | | E03 | | | E04 |E01=E01|E02=E02|E03=E03|E04=E04}}
{{familytree | | | | | | | | | | | | L01 | | | | | | | | | | | | | | | | | | | | | | | | | | |L01=<div style="float: left; text-align: left; line-height: 150% "> '''Order labs:'''<br>❑  Plasma electrolytes <br> ❑ Random blood sugar(Urgent) <br> ❑  Serum calcium <br> ❑  Toxicology screen <br> ❑ Antiepileptic drugs (AED) levels (if patient already on AED)<br> ❑ BUN/Cr.
{{familytree | | | | | | | | | | | | |!| | | |!| | | | |!| | }}
----
{{familytree | | | | | | | | | | | | F01 | | F02 | | | F03 |F01=F01|F02=F02|F03=F03}}
'''Order imaging studies:''' <br> ❑ MRI/CT scan <br>
----
'''Order EEG studies:'''<br> ❑ 12 lead EEG </div>}}
{{familytree | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | | | |}}
{{familytree | | | | | | | | | | | | M01 | | | | | | | | | | | | | | | | | | | | | | | | | | |M01='''Begin treatment with AED if:''' <br><div style="float: left; text-align: left; line-height: 150% "> ❑ There is a neurological deficit or <br> EEG shows unequivocal epileptic activity or <br>  Risk of having another seizure unacceptable to pt./family or <br> ❑ Brain imaging shows a structural abnormality </div>}}
{{familytree | | | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | | | | | | | | |}}
{{familytree | | | | | | | | | | | | N01 |-|-|-|-|-|-|-|-|-| N02 | | | | | | | | | | | | | |N01=Suspected epileptic seizure |N02=Diagnostic doubt}}
{{familytree | | | | | | | | | | | | |!| | | | | | | | | | | |!| | | | | | | | | | | | | | | |}}  
{{familytree | | | | | | | | | | | | O01 | | | | | | | | | | O02 | | | | | | | | | | | | | |O01=Refer to specialist in 2 weeks |O02=Refer to specialist}}  
{{familytree | | | | | | | | | | | | |!| | | | | | | | | | | |!| | | | | | | | | | | | | | | |}}
{{familytree | | | | | | | | | | | | P01 |-|-|-|-|-|-|-|-|-|-|'| | | | | | | | | | | | | | | |P01=Diagnosis by specialist}}
{{familytree | | | | | |,|-|-|-|-|-|-|+|-|-|-|-|-|-|.| | | | | | | | | | | | | | | | | | | | |}}
{{familytree | | | | | Q01 | | |,|-| Q02 | | | | | Q03 | | | | | | | | | | | | | | | | | | | |Q01=Uncertain |Q02=Epilepsy |Q03=Non-seizure disorder }}
{{familytree | | | | | |!| | | |!| | |!| | | | | | |!| | | | | | | | | | | | | | | | | | | | |}}
{{familytree | | | | | R01 |-|-|'| | R02 | | | | | R03 | | | | | | | | | | | | | | | | | | | |R01=Further investigations |R02=Classify & treat |R03=Refer to psychologist }}  
{{familytree/end}}
{{familytree/end}}

Revision as of 06:52, 31 December 2013

Resident Survival Guide
Introduction
Team
Guide
Page Template
Examine the Patient Template
Navigation Bar Template
Checklist
Topics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Karol Gema Hernandez, M.D. [2]

Definition

This section provides a short and straight to the point definition of the disease or symptom in one sentence.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated.

Common Causes

Management

Shown below is an algorithm summarizing the approach to heparin induced thrombocytopenia.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Examine the patient

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Consider alternative diagnosis

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Order labs:
❑ Plasma electrolytes
❑ Random blood sugar(Urgent)
❑ Serum calcium
❑ Toxicology screen
❑ Antiepileptic drugs (AED) levels (if patient already on AED)
❑ BUN/Cr.

Order imaging studies:
❑ MRI/CT scan


Order EEG studies:
❑ 12 lead EEG
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Begin treatment with AED if:
❑ There is a neurological deficit or
❑ EEG shows unequivocal epileptic activity or
❑ Risk of having another seizure unacceptable to pt./family or
❑ Brain imaging shows a structural abnormality
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Suspected epileptic seizure
 
 
 
 
 
 
 
 
 
Diagnostic doubt
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Refer to specialist in 2 weeks
 
 
 
 
 
 
 
 
 
Refer to specialist
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Diagnosis by specialist
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Uncertain
 
 
 
 
 
Epilepsy
 
 
 
 
Non-seizure disorder
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Further investigations
 
 
 
 
 
Classify & treat
 
 
 
 
Refer to psychologist