bowang0911/MedQuAD huggingface dataset:
Thrombocytopenia (THROM-bo-si-to-PE-ne-ah) is a condition in which your blood has a lower than normal number of blood cell fragments called platelets (PLATE-lets).
                
Platelets are made in your bone marrow along with other kinds of blood cells. They travel through your blood vessels and stick together (clot) to stop any bleeding that may happen if a blood vessel is damaged. Platelets also are called thrombocytes (THROM-bo-sites) because a clot also is called a thrombus.
                
Overview
                
When your blood has too few platelets, mild to serious bleeding can occur. Bleeding can occur inside your body (internal bleeding) or underneath your skin or from the surface of your skin (external bleeding).
                
A normal platelet count in adults ranges from 150,000 to 450,000 platelets per microliter of blood. A platelet count of less than 150,000 platelets per microliter is lower than normal. If your blood platelet count falls below normal, you have thrombocytopenia.
                
However, the risk for serious bleeding doesn't occur until the count becomes very lowless than 10,000 or 20,000 platelets per microliter. Mild bleeding sometimes occurs when the count is less than 50,000 platelets per microliter.
                
Many factors can cause a low platelet count, such as:
                
The body's bone marrow doesn't make enough platelets.
                
The bone marrow makes enough platelets, but the body destroys them or uses them up.
                
The spleen holds on to too many platelets. The spleen is an organ that normally stores about one-third of the body's platelets. It also helps your body fight infection and remove unwanted cell material.
                
A combination of the above factors.
                
How long thrombocytopenia lasts depends on its cause. It can last from days to years.
                
The treatment for this condition also depends on its cause and severity. Mild thrombocytopenia often doesn't require treatment. If the condition causes or puts you at risk for serious bleeding, you may need medicines or blood or platelet transfusions. Rarely, the spleen may need to be removed.
                
Outlook
                
Thrombocytopenia can be fatal, especially if the bleeding is severe or occurs in the brain. However, the overall outlook for people who have the condition is good, especially if the cause of the low platelet count is found and treated.
People who are at highest risk for thrombocytopenia are those affected by one of the conditions or factors discussed in "What Causes Thrombocytopenia?" This includes people who:
                
Have certain types of cancer, aplastic anemia, or autoimmune diseases
                
Are exposed to certain toxic chemicals
                
Have a reaction to certain medicines
                
Have certain viruses
                
Have certain genetic conditions
                
People at highest risk also include heavy alcohol drinkers and pregnant women.
Mild to serious bleeding causes the main signs and symptoms of thrombocytopenia. Bleeding can occur inside your body (internal bleeding) or underneath your skin or from the surface of your skin (external bleeding).
                
Signs and symptoms can appear suddenly or over time. Mild thrombocytopenia often has no signs or symptoms. Many times, it's found during a routine blood test.
                
Check with your doctor if you have any signs of bleeding. Severe thrombocytopenia can cause bleeding in almost any part of the body. Bleeding can lead to a medical emergency and should be treated right away.
                
External bleeding usually is the first sign of a low platelet count. External bleeding may cause purpura (PURR-purr-ah) or petechiae (peh-TEE-key-ay). Purpura are purple, brown, and red bruises. This bruising may happen easily and often. Petechiae are small red or purple dots on your skin.
                
Purpura and Petechiae
                

                
Other signs of external bleeding include:
                
Prolonged bleeding, even from minor cuts
                
Bleeding or oozing from the mouth or nose, especially nosebleeds or bleeding from brushing your teeth
                
Abnormal vaginal bleeding (especially heavy menstrual flow)
                
A lot of bleeding after surgery or dental work also might suggest a bleeding problem.
                
Heavy bleeding into the intestines or the brain (internal bleeding) is serious and can be fatal. Signs and symptoms include:
                
Blood in the urine or stool or bleeding from the rectum. Blood in the stool can appear as red blood or as a dark, tarry color. (Taking iron supplements also can cause dark, tarry stools.)
                
Headaches and other neurological symptoms. These problems are very rare, but you should discuss them with your doctor.
Treatment for thrombocytopenia depends on its cause and severity. The main goal of treatment is to prevent death and disability caused by bleeding.
                
If your condition is mild, you may not need treatment. A fully normal platelet count isn't necessary to prevent bleeding, even with severe cuts or accidents.
                
Thrombocytopenia often improves when its underlying cause is treated. People who inherit the condition usually don't need treatment.
                
If a reaction to a medicine is causing a low platelet count, your doctor may prescribe another medicine. Most people recover after the initial medicine has been stopped. For heparin-induced thrombocytopenia (HIT), stopping the heparin isn't enough. Often, you'll need another medicine to prevent blood clotting.
                
If your immune system is causing a low platelet count, your doctor may prescribe medicines to suppress the immune system.
                
Severe Thrombocytopenia
                
If your thrombocytopenia is severe, your doctor may prescribe treatments such as medicines, blood or platelet transfusions, or splenectomy.
                
Medicines
                
Your doctor may prescribe corticosteroids, also called steroids for short. Steroids may slow platelet destruction. These medicines can be given through a vein or by mouth. One example of this type of medicine is prednisone.
                
The steroids used to treat thrombocytopenia are different from illegal steroids taken by some athletes to enhance performance.
                
Your doctor may prescribe immunoglobulins or medicines like rituximab to block your immune system. These medicines are given through a vein. He or she also may prescribe other medicines, such as eltrombopag or romiplostim, to help your body make more platelets. The former comes as a tablet to take by mouth and the latter is given as an injection under the skin.
                
Blood or Platelet Transfusions
                
Blood or platelet transfusions are used to treat people who have active bleeding or are at a high risk of bleeding. During this procedure, a needle is used to insert an intravenous (IV) line into one of your blood vessels. Through this line, you receive healthy blood or platelets.
                
For more information about this procedure, go to the Health Topics Blood Transfusion article.
                
Splenectomy
                
A splenectomy is surgery to remove the spleen. This surgery may be used if treatment with medicines doesn't work. This surgery mostly is used for adults who have immune thrombocytopenia (ITP). However, medicines often are the first course of treatment.
Whether you can prevent thrombocytopenia depends on its specific cause. Usually the condition can't be prevented. However, you can take steps to prevent health problems associated with thrombocytopenia. For example:
                
Avoid heavy drinking. Alcohol slows the production of platelets.
                
Try to avoid contact with toxic chemicals. Chemicals such as pesticides, arsenic, and benzene can slow the production of platelets.
                
Avoid medicines that you know have decreased your platelet count in the past.
                
Be aware of medicines that may affect your platelets and raise your risk of bleeding. Two examples of such medicines are aspirin and ibuprofen. These medicines may thin your blood too much.
                
Talk with your doctor about getting vaccinated for viruses that can affect your platelets. You may need vaccines for mumps, measles, rubella, and chickenpox. You may want to have your child vaccinated for these viruses as well. Talk with your child's doctor about these vaccines.
In most cases, an autoimmune response is thought to cause immune thrombocytopenia (ITP).
                
Normally, your immune system helps your body fight off infections and diseases. In ITP, however, your immune system attacks and destroys your body's platelets by mistake. Why this happens isn't known.
                
In some people, ITP may be linked to viral or bacterial infections, such as HIV, hepatitis C, or H. pylori.
                
Children who have acute (short-term) ITP often have had recent viral infections. These infections may "trigger" or set off the immune reaction that leads to ITP.
Immune thrombocytopenia (ITP) is a fairly common blood disorder. Both children and adults can develop ITP.
                
Children usually have the acute (short-term) type of ITP. Acute ITP often develops after a viral infection.
                
Adults tend to have the chronic (long-lasting) type of ITP. Women are two to three times more likely than men to develop chronic ITP.
                
The number of cases of ITP is rising because routine blood tests that can detect a low platelet count are being done more often.
                
ITP can't be passed from one person to another.
Immune thrombocytopenia (ITP) may not cause any signs or symptoms. However, ITP can cause bleeding inside the body (internal bleeding) or underneath or from the skin (external bleeding). Signs of bleeding may include:
                
Bruising or purplish areas on the skin or mucous membranes (such as in the mouth). These bruises are called purpura. They're caused by bleeding under the skin, and they may occur for no known reason.
                
Pinpoint red spots on the skin called petechiae. These spots often are found in groups and may look like a rash. Bleeding under the skin causes petechiae.
                
A collection of clotted or partially clotted blood under the skin that looks or feels like a lump. This is called a hematoma.
                
Nosebleeds or bleeding from the gums (for example, during dental work).
                
Blood in the urine or stool (bowel movement).
                
Any kind of bleeding that's hard to stop could be a sign of ITP. This includes menstrual bleeding that's heavier than normal. Bleeding in the brain is rare, and its symptoms may vary.
                
A low platelet count doesn't directly cause pain, problems concentrating, or other symptoms. However, a low platelet count might be associated with fatigue (tiredness).
Your doctor will diagnose immune thrombocytopenia (ITP) based on your medical history, a physical exam, and test results.
                
Your doctor will want to make sure that your low platelet count isn't due to another condition (such as an infection) or medicines you're taking (such as chemotherapy medicines or aspirin).
                
Medical History
                
Your doctor may ask about:
                
Your signs and symptoms of bleeding and any other signs or symptoms you're having
                
Whether you have illnesses that could lower your platelet count or cause bleeding
                
Medicines or any over-the-counter supplements or remedies you take that could cause bleeding or lower your platelet count
                
Physical Exam
                
During a physical exam, your doctor will look for signs of bleeding and infection. For example, your doctor may look for purplish areas on the skin or mucous membranes and pinpoint red spots on the skin. These are signs of bleeding under the skin.
                
Diagnostic Tests
                
You'll likely have blood tests to check your platelet count. These tests usually include:
                
A complete blood count. This test checks the number of red blood cells, white blood cells, and platelets in your blood. In ITP, the red and white blood cell counts are normal, but the platelet count is low.
                
A blood smear. For this test, some of your blood is put on a slide. A microscope is used to look at your platelets and other blood cells.
                
You also may have a blood test to check for the antibodies (proteins) that attack platelets.
                
If blood tests show that your platelet count is low, your doctor may recommend more tests to confirm a diagnosis of ITP. For example, bone marrow tests can show whether your bone marrow is making enough platelets.
                
If you're at risk for HIV, hepatitis C, or H. pylori, your doctor may screen you for these infections, which might be linked to ITP.
                
Some people who have mild ITP have few or no signs of bleeding. They may be diagnosed only if a blood test done for another reason shows that they have low platelet counts.
You can't prevent immune thrombocytopenia (ITP), but you can prevent its complications.
                
Talk with your doctor about which medicines are safe for you. Your doctor may advise you to avoid medicines that can affect your platelets and increase your risk of bleeding. Examples of such medicines include aspirin and ibuprofen.
                
Protect yourself from injuries that can cause bruising or bleeding.
                
Seek treatment right away if you develop any infections. Report any symptoms of infection, such as a fever, to your doctor. This is very important for people who have ITP and have had their spleens removed.
Espaol
                
An arrhythmia (ah-RITH-me-ah) is a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm.
                
A heartbeat that is too fast is called tachycardia (TAK-ih-KAR-de-ah). A heartbeat that is too slow is called bradycardia (bray-de-KAR-de-ah).
                
Most arrhythmias are harmless, but some can be serious or even life threatening. During an arrhythmia, the heart may not be able to pump enough blood to the body. Lack of blood flow can damage the brain, heart, and other organs.
                
Understanding the Heart's Electrical System
                
To understand arrhythmias, it helps to understand the heart's internal electrical system. The heart's electrical system controls the rate and rhythm of the heartbeat.
                
With each heartbeat, an electrical signal spreads from the top of the heart to the bottom. As the signal travels, it causes the heart to contract and pump blood.
                
Each electrical signal begins in a group of cells called the sinus node or sinoatrial (SA) node. The SA node is located in the heart's upper right chamber, the right atrium (AY-tree-um). In a healthy adult heart at rest, the SA node fires off an electrical signal to begin a new heartbeat 60 to 100 times a minute.
                
From the SA node, the electrical signal travels through special pathways in the right and left atria. This causes the atria to contract and pump blood into the heart's two lower chambers, the ventricles (VEN-trih-kuls).
                
The electrical signal then moves down to a group of cells called the atrioventricular (AV) node, located between the atria and the ventricles. Here, the signal slows down just a little, allowing the ventricles time to finish filling with blood.
                
The electrical signal then leaves the AV node and travels along a pathway called the bundle of His. This pathway divides into a right bundle branch and a left bundle branch. The signal goes down these branches to the ventricles, causing them to contract and pump blood to the lungs and the rest of the body.
                
The ventricles then relax, and the heartbeat process starts all over again in the SA node. (For more information about the heart's electrical system, including detailed animations, go to the Health Topics How the Heart Works article.)
                
A problem with any part of this process can cause an arrhythmia. For example, in atrial fibrillation (A-tre-al fi-bri-LA-shun), a common type of arrhythmia, electrical signals travel through the atria in a fast and disorganized way. This causes the atria to quiver instead of contract.
                
Outlook
                
There are many types of arrhythmia. Most arrhythmias are harmless, but some are not. The outlook for a person who has an arrhythmia depends on the type and severity of the arrhythmia.
                
Even serious arrhythmias often can be successfully treated. Most people who have arrhythmias are able to live normal, healthy lives.
An arrhythmia can occur if the electrical signals that control the heartbeat are delayed or blocked. This can happen if the special nerve cells that produce electrical signals don't work properly. It also can happen if the electrical signals don't travel normally through the heart.
                
An arrhythmia also can occur if another part of the heart starts to produce electrical signals. This adds to the signals from the special nerve cells and disrupts the normal heartbeat.
                
Smoking, heavy alcohol use, use of some drugs (such as cocaine or amphetamines), use of some prescription or over-the-counter medicines, or too much caffeine or nicotine can lead to arrhythmias in some people.
                
Strong emotional stress or anger can make the heart work harder, raise blood pressure, and release stress hormones. Sometimes these reactions can lead to arrhythmias.
                
A heart attack or other condition that damages the heart's electrical system also can cause arrhythmias. Examples of such conditions include high blood pressure, coronary heart disease, heart failure, an overactive or underactive thyroid gland (too much or too little thyroid hormone produced), and rheumatic heart disease.
                
Congenital (kon-JEN-ih-tal) heart defects can cause some arrhythmias, such as Wolff-Parkinson-White syndrome. The term "congenital means the defect is present at birth.
                
Sometimes the cause of arrhythmias is unknown.
Arrhythmias are very common in older adults. Atrial fibrillation (a common type of arrhythmia that can cause problems) affects millions of people, and the number is rising.
                
Most serious arrhythmias affect people older than 60. This is because older adults are more likely to have heart disease and other health problems that can lead to arrhythmias.
                
Older adults also tend to be more sensitive to the side effects of medicines, some of which can cause arrhythmias. Some medicines used to treat arrhythmias can even cause arrhythmias as a side effect.
                
Some types of arrhythmia happen more often in children and young adults. Paroxysmal supraventricular tachycardia (PSVT), including Wolff-Parkinson-White syndrome, is more common in young people. PSVT is a fast heart rate that begins and ends suddenly.
                
Major Risk Factors
                
Arrhythmias are more common in people who have diseases or conditions that weaken the heart, such as:
                
Heart attack
                
Heart failure or cardiomyopathy, which weakens the heart and changes the way electrical signals move through the heart
                
Heart tissue that's too thick or stiff or that hasn't formed normally
                
Leaking or narrowed heart valves, which make the heart work too hard and can lead to heart failure
                
Congenital heart defects (defects present at birth) that affect the heart's structure or function
                
Other conditions also can raise the risk for arrhythmias, such as:
                
High blood pressure
                
Infections that damage the heart muscle or the sac around the heart
                
Diabetes, which increases the risk of high blood pressure and coronary heart disease
                
Sleep apnea, which can stress the heart because the heart doesn't get enough oxygen
                
An overactive or underactive thyroid gland (too much or too little thyroid hormone in the body)
                
Several other risk factors also can raise your risk for arrhythmias. Examples include heart surgery, certain drugs (such as cocaine or amphetamines), or an imbalance of chemicals or other substances (such as potassium) in the bloodstream.
Many arrhythmias cause no signs or symptoms. When signs or symptoms are present, the most common ones are:
                
Palpitations (feelings that your heart is skipping a beat, fluttering, or beating too hard or fast)
                
A slow heartbeat
                
An irregular heartbeat
                
Feeling pauses between heartbeats
                
More serious signs and symptoms include:
                
Anxiety
                
Weakness, dizziness, and light-headedness
                
Fainting or nearly fainting
                
Sweating
                
Shortness of breath
                
Chest pain