In this high-yield episode, we build a visual memory palace down the “Highway to Hell” of emergency thrombocytopenia syndromes. Each stop reveals a unique and dangerous cause of low platelets you’ll encounter in the ED—brought to life through vivid storytelling, unforgettable characters, and layered mnemonics.
🚑 What You’ll Learn (Quick Hits):
• TTP – Thrombotic Thrombocytopenic Purpura
⚠️ Medical emergency! Think fever, renal failure, confusion, and schistocytes. LDH ↑, haptoglobin ↓. No platelets? No transfusions—start plasma exchange.
• HUS – Hemolytic Uremic Syndrome
👶 Usually in kids post-E. coli O157:H7 diarrhea. Watch for MAHA, AKI, and thrombocytopenia. Supportive care is key.
• ITP – Immune Thrombocytopenic Purpura
🍽 Isolated platelets on the floor. In kids: post-viral; in adults: chronic. No MAHA. Often treated with steroids or IVIG.
• DIC – Disseminated Intravascular Coagulation
🎲 The DIC casino. Caused by trauma, sepsis, OB complications, or malignancy. PT/PTT ↑, D-dimer ↑, fibrinogen ↓, schistocytes present. Treat the cause!
• HELLP – Hemolysis, Elevated Liver Enzymes, Low Platelets
🔥 Pregnant patient near the end of the road—hypertension, RUQ pain, and MAHA. Delivery is the only definitive treatment.
• HIT – Heparin-Induced Thrombocytopenia
🕷 A clotting catastrophe. 5–10 days post-heparin. Watch for new clots and falling platelets. Stop heparin and start a direct thrombin inhibitor like argatroban.
💡 Distinctions to Remember:
• MAHA: Present in TTP, HUS, DIC, HELLP (look for schistocytes, LDH ↑, haptoglobin ↓).
• Isolated thrombocytopenia: Think ITP.
• Timing: HIT = 5–10 days after heparin; HUS = 5–10 days after diarrheal illness.
• Treatment: TTP = plasma exchange, DIC = treat cause + FFP/cryoprecipitate, HELLP = deliver, HIT = stop heparin.
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🧠 Bonus: Visual mnemonics and character scenes help lock it all in. This episode blends storytelling, pathophys, and pattern recognition so you’ll never forget what each condition looks like in real life.
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