5.

Enumerate conditions associated with an increased or decreases platelet count

Decreased Platelets (Thrombocytopenia)
o Decreased Production of Platelets
Congenita Hypoplasia:
May-Hegglin anomaly
Bernard-Soulier syndrome
Fechtner syndrome
Sebastian syndrome
Epstein syndrome
Montreal platelet syndrome
Fanconi anemia
Wiskott-Aldrich syndrome
Thrombocytopenia with absent radii (TAR) syndrome
Congenital amegakaryocytic thrombocytopenia
Autosomal dominant and X-linked thrombocytopenia
Neonatal Hypoplasia
Toxoplasma infection, Rubella Cytomegalovirus, Herpes
(TORCH), HIV, Chlorothiazide Diuretics, Hypoglycemic
tolbutamide
Ineffecive Thrombopoiesis
Megaloblastic Anemias
o Pernicious Anemia
o Folic Acid Deficiency
o Vitamin B12 deficiency
Acquired
Viral
o Hepatitis B, Hepatitis C, HIV, CMV, Epstein-Barr virus,
Rubella virus, Varicella-Zoster virus
Bacterial
o Meningococcemia
Unexplained Thrombocytopenia
o Myeloma, Lymphoma, Metastatic Cancer, Myelofibrosis
Drug induced
o Methotrexate,
Busulfan,
Cytosine
arabinoside,
cyclophosphate, cisplatin, Zidovudine, ethanol
o Increased Platelet Destruction
Immune
Acute and chronic immune thrombocytopenic purpura
Drug induced: immunologic
Heparin induced thrombocytopenia
Neonatal alloimmune (isoimmune neonatal) thrombocytopenia

 Neonatal autoimmune thrombocytopenia

Posttransfusion Purpura
Posttransfusion isoimmune thrombocytopenia
Secondary autoimmune thrombocytopenia
Nonimmune
Thrombocytopenia in pregnancy and preeclampsia
Human immunodeficiency virus infection
Hemolytic disease of the newborn
Thrombotic thrombocytopenia purpura
Disseminated intravascular coagulation
Hemolytic uremic syndrome
Drug induced
o Abnormalities of Distribution or Dilution
Splenic sequestration
Kasabach-Merritt syndrome
Hypothermia
Loss of platelets: massive blood transfusions, extracorporeal circulation
Increased Platelets (Thrombocytosis)
o Conditions Associated with Reactive Thrombocytosis
Blood loss and surgery
Splenectomy
Iron deficiency anemia
Inflammation and disease
Kawasaki Disease
Hodgkin Disease
Stress or exercise
Rebound Thrombocytosis
o Myeloproliferative Disorders Associated with Thrombocytosis
Polycythemia vera
Chronic myelogenous leukemia
Myelofibrosis with myeloid metaplasia
Thrombocythemia: essential or primary
6. What are the sources of errors associated in manual platelet counting?
a. Inadequate mixing and poor collection of the sample can cause the platelets to clump
on the hemacytometer. If the problem persists after redilution, a new sample is needed.
A finger-stick sample is less desirable because of the adhesive quality of the platelets.
b. Dirt in the pipette, hemacytometer, or diluting fluid may cause the counts to be
inaccurate.
c. If fewer than 50 platelets are counted on each side, the procedure should be repeated by
diluting the blood to 1 : 20 using calibrated pipettes. If more than 500 platelets are

counted on each side, a 1 : 200 dilution should be made. The appropriate dilution factor
should be used in calculating the results.
d. If the patient has a normal platelet count, the red cell area may be counted. Then, the
area is 0.2 mm2 on each side.
e. The phenomenon of platelet satellitosis may occur when EDTA anticoagulant is
used. This refers to the adherence of platelets around neutrophils, producing a ring or
satellite effect. Using sodium citrate as the anticoagulant should correct this problem.
Because of the dilution in the citrate tubes, it is necessary to multiply the obtained
platelet count by 1.1 for accuracy.