Secondary Logo

Journal Logo

When and how to treat childhood immune thrombocytopenia

doi: 10.1097/01.NPR.0000488684.64778.55
CE Connection
Free

For more than 183 additional continuing education articles related to Advanced Practice Nursing topics, go to NursingCenter.com/CE.

Earn CE credit online: Go to www.nursingcenter.com/CE/NP and receive a certificate within minutes.

Back to Top | Article Outline

INSTRUCTIONS When and how to treat childhood immune thrombocytopenia

TEST INSTRUCTIONS

  • To take the test online, go to our secure website at www.nursingcenter.com/ce/NP.
  • On the print form, record your answers in the test answer section of the CE enrollment form on page 26. Each question has only one correct answer. You may make copies of these forms.
  • Complete the registration information and course evaluation. Mail the completed form and registration fee of $21.95 to: Lippincott Williams & Wilkins, CE Group, 74 Brick Blvd., Bldg. 4, Suite 206, Brick, NJ 08723. We will mail your certificate in 4 to 6 weeks. For faster service, include a fax number and we will fax your certificate within 2 business days of receiving your enrollment form.
  • You will receive your CE certificate of earned contact hours and an answer key to review your results.There is no minimum passing grade.
  • Registration deadline is July 31, 2018
Back to Top | Article Outline

DISCOUNTS and CUSTOMER SERVICE

  • Send two or more tests in any nursing journal published by Lippincott Williams & Wilkins together and deduct $0.95 from the price of each test.
  • We also offer CE accounts for hospitals and other healthcare facilities on nursingcenter.com. Call 1-800-787-8985 for details.
Back to Top | Article Outline

PROVIDER ACCREDITATION

Lippincott Williams & Wilkins, publisher of The Nurse Practitioner journal, will award 2.0 contact hours for this continuing nursing education activity.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida CE Broker #50-1223.

Your certificate is valid in all states. This activity has been assigned 0.5 pharmacology credits.

When and how to treat childhood immune thrombocytopenia

General Purpose: To provide information on childhood ITP and its treatment. Learning Objectives/Outcomes: After completing this continuing-education activity, you should be able to: 1. Examine the features, pathophysiology, and diagnosis of ITP in children. 2. Select current treatment options for patients with ITP.

  1. In general, which statement about ITP is accurate?
    1. It affects males to females at a ratio of 2:1.
    2. It is a benign, self-limiting phenomenon.
    3. Its peak incidence is in children ages 10 to 12.
  2. Most cases of childhood ITP resolve within the first
    1. 2 months.
    2. 6 months.
    3. year.
  3. Persistent ITP is defined as ITP
    1. in the first 3 months after diagnosis.
    2. between 3 and 12 months after diagnosis.
    3. lasting more than 12 months after diagnosis.
  4. In 72% of newly diagnosed cases, the autoimmune reaction of ITP can be linked to
    1. a preceding illness.
    2. a recent injury.
    3. an episode of bleeding (for example, epistaxis).
  5. In ITP, platelets opsonized by IgG are cleared prematurely and at an accelerated rate by macrophages in the
    1. spleen.
    2. liver.
    3. bone marrow.
  6. The author notes that ITP may be triggered in children ages 1 to 3, especially after vaccination with
    1. diphtheria-pertussis-tetanus.
    2. pneumococcal vaccine.
    3. MMR.
  7. In the 2008 study by Arnold and colleagues, children with secondary ITP related to pylori infection were treated successfully
    1. with one dose of IVIG.
    2. through eradication of the bacteria.
    3. with a taper of oral corticosteroids.
  8. Key findings in an ITP workup include a
    1. family history of bleeding disorders.
    2. gradual onset.
    3. generally well-appearing child.
  9. Lab analysis for a child with ITP reveals
    1. a platelet count of 110,000/mcL or less.
    2. hemolytic anemia if there was significant blood loss.
    3. isolated thrombocytopenia with no other cell lines affected.
  10. A patient is at higher risk for complications from ITP in the presence of
    1. petechiae.
    2. bleeding gums.
    3. bruising.
  11. Which age group is at an increased risk for fatal bleeds from ITP?
    1. toddlers
    2. school-age children
    3. adolescents
  12. As noted in the article, diagnosis of ITP generally is made via history, physical exam, and
    1. bone marrow aspirates.
    2. a compete blood cell count.
    3. splenic ultrasound.
  13. Children with ITP without bleeding are managed with
    1. observation alone.
    2. corticosteroids.
    3. anti-D immunoglobulin.
  14. A potential adverse reaction from anti-D immunoglobulin treatment is
    1. progressive multifocal leukoencephalopathy.
    2. decreased vertical growth.
    3. disseminated intravascular coagulation.
  15. Which statement is correct regarding the off-label use of rituximab to treat persistent ITP?
    1. Without spontaneous remission, children will need multiple treatments.
    2. It is associated with fewer than three adverse reactions in children.
    3. The platelet count will rise within a few days.
  16. What can be used in place of splenectomy in children in the first year of treatment for persistent ITP that is unresponsive to previous therapies?
    1. romiplostim
    2. eltrombopag
    3. high-dose dexamethasone
  17. At diagnosis, common findings associated with chronic ITP include
    1. initial age 6 or older.
    2. the presence of other autoimmune diseases.
    3. male gender.
  18. Romiplostim for the treatment of ITP works by
    1. increasing platelet production.
    2. decreasing the production of autoantibodies.
    3. stunting endogenous TPO activity.
Figure

Figure

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.