Haem: Thrombocytosis: Free MSRA Podcast

🩸 FREE MSRA PODCAST – Thrombocytosis: Clot Risks, JAK2& Clinical Clues 🎧This episode breaksdown everything you need to know about thrombocytosisfor the MSRA exam – from essentialthrombocythaemia (ET) and JAK2 mutationsto secondary/reactive causes like infections, inflammation, and irondeficiency. If you've ever seen a high platelet count and thought, “What now?”– this one’s for you. 🧠Key Learning Points📌DefinitionThrombocytosis = platelet count >450 x10⁹/L• Primary = bone marrow disorder (essentialthrombocythaemia)• Secondary = reaction to another condition(infection, inflammation)• Relative = due to plasma volume loss(dehydration) 📌Causes🔬PrimaryThrombocytosis (ET)• JAK2 V617F mutation (~50% of ET cases)• Bone marrowoverproduction of platelets• Megakaryocytehyperplasia seen on biopsy🔬Secondary (Reactive)Thrombocytosis• Infection(bacterial, viral, parasitic)• Inflammation(e.g., IBD, rheumatoid arthritis)• Iron deficiencyanaemia• Post-splenectomy• Trauma, surgery,bleeding• Cancer (lung,renal, ovarian, breast)• Cytokine therapy,rebound after chemo🧠 Mnemonic: I-CLIP IT –Infection, Cancer, Loss (blood), Inflammation, Post-op, Iron deficiency, Trauma 📌Pathophysiology• Primary: Autonomous megakaryocyte proliferation→ ↑ platelets ± impaired function → thrombosis or paradoxical bleeding• Secondary: Cytokine-driven response tophysiological stress → ↑ platelet production• Platelet functionis typically preserved in secondary causes 📌Symptoms• Often asymptomatic(especially if mild)• ET symptoms: – Headaches,dizziness, blurred vision – Burning pain inhands/feet (erythromelalgia) – Paresthesia,fatigue, visual changes – Thrombotic events(DVT, PE, stroke) – Bleeding (esp. GItract)• Pregnancycomplications: ↑ miscarriage risk, placental issues 📌Clinical Signs• Splenomegaly (upto 50% in ET)• Hepatomegaly (lesscommon)• Otherwise oftenunremarkable• Secondarythrombocytosis signs depend on underlying cause 📌Investigations🔍 Full Blood Count: Persistent platelets >450🔍 JAK2, MPL, CALR mutation testing🔍 Inflammatory markers: CRP, ESR🔍 Iron studies, Ferritin🔍 Bone marrow biopsy: ET diagnosis, megakaryocytehyperplasia🔍 Imaging: rule out malignancy or inflammation🔍 Exclude secondary causes via thorough history +labs 📌Management🎯PrimaryThrombocytosis (ET)• Low-dose aspirin – reduce thrombotic risk• Cytoreductive therapy: – Hydroxyurea – first-line – Interferon-alpha – for younger/pregnantpatients – Anagrelide – alternative• Plateletpheresis – emergency platelet removalif urgent• Target: Platelets<450 x10⁹/L• Pre-operativecytoreduction often needed🎯SecondaryThrombocytosis• Treat the underlying cause – e.g., infection,inflammation• Aspirin – only if high thrombotic risk• Platelet countoften normalises once trigger is resolved 📌Complications• Thrombosis – stroke, MI, DVT, PE, mesentericischaemia• Bleeding – especially when platelets >1,000• Progression to AML or myelofibrosis (rare inET)• Pregnancy loss orcomplications in women with ET 📎More MSRA Resourcesfor Thrombocytosis📝 Revision Notes:https://www.passthemsra.com/topic/thrombocytosis-revision-notes/🧠 Flashcards:https://www.passthemsra.com/topic/thrombocytosis-flashcards/💬 Accordion Q&A Notes:https://www.passthemsra.com/topic/thrombocytosis-accordion-qa-notes/🚀 Rapid Quiz:https://www.passthemsra.com/topic/thrombocytosis-rapid-quiz/🎓 Haematology Course:https://www.passthemsra.com/courses/haematology-for-the-msra/ #MSRA#Thrombocytosis #EssentialThrombocythaemia #JAK2 #ET #PlateletDisorders#HaematologyMSRA #PassTheMSRA #FreeMSRA #MSRAFlashcards #MSRAQuiz#MSRAAccordions #MSRARevisionNotes #MyeloproliferativeDisorders #GPTraining#MedicalRevision