Cardiology MCQ: Heparin induced thrombocytopenia syndrome (HIT)

Heparin induced thrombocytopenia (HIT) syndrome with thrombosis can be treated with: a) Unfractionated heparin b) Low molecular weight heparin c) Bivalirudin d) None of the above Correct answer: c) Bivalirudin Bivalirudin and Argatroban are two direct thrombin inhibitors which can be used in the treatment of Heparin induced thrombocytopenia (HIT) syndrome with thrombosis. Though low molecular weight heparins are less likely to cause heparin induced thrombocytopenia, once the syndrome is established, switching over to low molecular weight heparin from unfractionated heparin is not useful. The incidence of the syndrome has been coming down to the higher usage of low molecular weight heparin than unfractionated heparin. Heparin induced thrombocytopenia with thrombosis is known as heparin induced thrombosis-thrombocytopenia syndrome (HITTS) [Arthur CK et al. The heparin induced thrombosis-thrombocytopenia syndrome (H.I.T.T.S.): a review. Pathology. 1985 Jan;17(1):82-6]. HITTS has a high morbidity and mortality. Mild heparin induced thrombocytopenia (HIT) is a result of direct agglutinating effect of heparin on platelets and resolves on stopping heparin. This occurs early within about 4 days and is not mediated by immune complexes. It is not associated with thrombosis and may not worsen even if heparin therapy is continued. Severe thrombocytopenia occurs between 4-14 days and is immune complex mediated. This entity is known as HITTS as it is associated with both arterial and veno...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Argatroban Bivalirudin Heparin induced thrombocytopenia HIT Source Type: blogs