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Core IM | Internal Medicine Podcast

#53 Heparin-Induced Thrombocytopenia: 5 Pearls Segment

Core IM | Internal Medicine Podcast

Core IM Team

Mental Health, Education, Health & Fitness, Medicine

4.81K Ratings

🗓️ 13 November 2019

⏱️ 48 minutes

🧾️ Download transcript

Summary

Get CME Credit (https://www.acponline.org/cme-moc/online-learning-center/heparin-induced-thrombocytopenia-5-pearls-segment) with ACP! Full Transcript with references and show notes (https://www.coreimpodcast.com/2019/11/13/5-pearls-on-heparin-induced-thrombocytopenia/) Time Stamps 4:30 What is the daily risk of thrombosis if HIT Is left untreated? 5:40 What happens during platelet activation? 07:11 How long does it take for patients to develop for IgG antibodies to Heparin to form? 09:52 Is HIT common? 10:28 Who is at higher risk for HIT? 11:48 Why does low molecular weight heparin have a lower risk for HIT than unfractionated heparin? 15:30 Approach to thrombocytopenia 17:44 How do medications cause thrombocytopenia? 18:38 With medications, what is the time course between medication initiation and thrombocytopenia? 22:20 What is the sensitivity and specificity of anti-PF4 antibody? 23:58 How does the serotonin-release assay (SRA) work? 29:10 What type of anticoagulant do you choose for treating HIT? 31:58 Why is it important to not use warfarin in patients with platelet counts Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Transcript

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0:00.0

Hi everyone this quorum episode this month will count for

0:03.9

ceme credit with ACP yay

0:06.7

we will link the exact URL in the show notes so click on the link answer three

0:10.3

questions and get ceme credit. And with that, Q the intro.

0:15.0

This is Dr. Marty Am Five Pearls podcast.

0:27.0

Bringing you High Yield Evidence-based Pearls.

0:29.3

Bring you High Yield Evidence-Based Pearls.

0:32.1

Today we're discussing Heparin-induced thrombocytopinia,

0:35.0

which we're going to affectionately refer to as hit for the remainder of the episode.

0:39.0

Right, basically, this is going to be everything an internist ever needed to know about him with a little bit of extra sprinkles on Heparin aha's and Thermosetopenea goodness.

0:48.6

Nice.

0:49.6

If you look back in the literature a couple decades ago, so before you and I were in practice, the

0:57.3

concern was raising awareness about hit.

0:59.7

The concern was missing cases of hit. And while that still happens occasionally, I think that we were

1:06.8

so zealous with our educational campaign that we sort of pushed the pendulum may be a little bit too far.

1:15.0

And so now I think a much more common problem than missing it is

1:21.0

over suspecting, over diagnosing, and over-treating it, which can lead to harm in and of itself.

1:29.0

That's Dr. Adam Sucre, a hematologist and director of the Penn Comprehensive Hemophilia and

1:34.4

thrombosis program.

1:36.0

You'll also hear from Dr. Lorry Lincoln, a thrombosis consultant at McMaster University

1:40.6

doing the recap.

1:42.0

Both were authors of the 2018 American Society of

...

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