starcraftbw
Forum Senior
Topics: 13
Posts: 166
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HIV patient comes with thromocytopenia (platelet = 90k). what's your best treatment? her CD4 is 510, viral load is 10k
a) AZT
b) steroid
c) splenectomy
d) HAART
e) no need to treat
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| Dr.D
Forum Senior
Topics: 22
Posts: 191
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E ???
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| peraspera
Forum Elite
Topics: 38
Posts: 233
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I will go with A,
AZT ( Zidovudine): Because HIV-induced thrombocytopenia is also due to the direct effect of the virus on megakaryocytes, antiretroviral therapy often helps provide more sustained increases in the platelet count. Treatment with AZT has been studied extensively and is associated with a significant increase in platelet counts in approximately 40-70% of patients.
Guidelines for starting therapy:
CD< 500, viral load > 20.000, But E can be too
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| Doc750
transfer:step 3 prison
Topics: 52
Posts: 634
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E, no tx until platlet count below 40k
___________________
Experience is a hard teacher because she gives the test first, and the lesson afterwards.
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| doyoudig
Forum Guru
Topics: 144
Posts: 613
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a) AZT
b) steroid
c) splenectomy -- Sounds like the Best Rx?
d) HAART
e) no need to treat
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| peraspera
Forum Elite
Topics: 38
Posts: 233
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B.  Intravenous immunoglobulin and prednisone: Both high-dose intravenous immunoglobulin (eg, 0.4 g/kg/d infused for 3-5 d) and high-dose intravenous glucocorticoids (eg, prednisone 1-2 mg/kg/d) can induce transient increases in the platelet count, but they generally do not provide a sustained response. These therapies should be administered to patients with platelet counts less than 20,000/mL or with documented bleeding.
C. Splenectomy is an effective long-term treatment. Although splenectomy is not associated with an increased mortality rate, the risk of fulminant infections with encapsulated bacteria increases.
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| starcraftbw
Forum Senior
Topics: 13
Posts: 166
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the anwer is A....... not enough criteria for HAART..... steroid will have replased thrombocytopenia after taper down........
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