Coombs test is negative because although the IgG antibodies are present, they are not against RBC's or platelets, they are against the enzyme which breaks down vWF.
The unique and funny way of explaining stuff and the way tough topics are broken down into easy and digestible bits are a boon to have, before exams. Keep up God's work good sir!! Left you a like❤
OMG I love this so much! thank you. i just started working in hematology after working for years in onco and ITU. I was having a hard time making patterns and organizing my studies. this extremely helps! thank you!!!!!
I was diagnosed with TTP a couple of weeks ago. Still in the hospital, but PEX got things in order (the last one was three days ago). This video was extremely helpful and helped me understand what's happening to me. Thank you! Btw, they suspect I might actually be one of those extremely rare cases of inherited TTP. Gotta start buying lottery tickets 😂
Update: ADAMTS13 Inhibitor test came back positive so at least I was getting the right treatment. And it has been working. ADAMTS13 activity is in the normal range (0.41) and platelet count has stabilized in the lower end of the normal range. So far so good!
@@salamsthoughts5842 couple of bruises on the legs, a bit of confusion, and petechiae (both legs). I was feeling unwell for a few days before all of these symptoms appeared.
@@salamsthoughts5842 everything has been normal after the treatment. Platelets normalized around 160 (even though they dropped to 130 for a couple of weeks) and ADAMTS13 activity has been between 0.48 and 0.79 (doing the test every month).
Great video! Unlike many professors you explain in a clear and simple way! In this regard, I was told that in TTP, unlike DIC, there is no hemorrhagic risk and the purpura is due to blood extravasation following endothelial damage due to ischemia caused by the formation of microthrombi. But i was wondering...Isn't poropra a result of thrombocytopenia? Furthermore, shouldn't thrombocytopenia (
Great question! There might be a hemorrhagic risk, but it really depends on how low the platelet count. A person with a platelet count of 4,000 is a completely different story than a patient with a platelet count of 48,000. Also, we have to take the coagulation factors into consideration. Platelets usually protect us from superficial bleeding, whereas the coagulation factors protect us from deep tissue bleeding (e.g. internal bleeding). Hope that helps!
I have 2 boys and now my baby girl husband and I are carriers..... But no matter what science says nothing is impossible for God Doctors are always surprise how my boy body react prayers are so powerful never stop believing God is amazing and always can do miracle's TTP🔗chain breakers Philippians 4:13🙏❤ thank you Dr beautiful explained
Hello, doctor I have one question. In TTP , vWf is overly active,platelets are adhered to form a thrombosis and the number of circulated free platelets decrease. In Bernard Soulier disease vWf is normal but receptor is inactive. It doesn't adhere to form thrombosis. So,they should be circulated freely through the bloodstream .But why ,platelet number decrease instead of increasing ?
Great question! From my understanding, lack of GP1b also leads to the platelets being abnormally shaped in Bernard-Soulier syndrome (i.e. "Giant platelet cells") and, as you mentioned, since they are freely circulating in the bloodstream due to lack the ability for adhesion, they are also subject to shearing forces, leading to further shape irregularities. This, combined with their increased freely circulating quantity leads to detection by the immune system and hence the their destruction and clearance by the immune system.
Hello, I just got out of the hospital after a bought with TTP. Luckily I caught it in time before it took me. I’m 44 years old. My blood counts are normal. I had about 6 sessions of plasmapheresis. Its now my second night back at home after discharge, and at night I tend to shake a little bit when lying down. Is this just my body slowly accommodating to the plasmapheresis process? I’m also on prednisone. Thank you so much.
Im pretty sure its because you are getting Schistocytes from the platelet microthrombi that is being formed in TTP. Its shearing the rbcs as they come along and so now that they are effected/damaged, the spleen filters them out which causes the spleen to overwork leading to work induced hyperplasia. i.e. splenomegaly.
Or it could be what SixthKiller is saying and just extramedullary hematopoesis occurring due to the loss of platelets but i dont rlly believe that since there is no hepatomegaly.
Where do the neurologic symptoms and fever come from? I have watched the video carefully and loved it, but I don't really get the reasons for these additional symptoms
Just yesterday I saw a case of TTP from a dog bite. It escalated to sepsis and internal bleeding...the lab results and images all indicate an aquired TTP. Really interesting.
9:56 😂 I had this aquired ttp as a kid about 20 yr ago just wanted to understand it a bit better for some reason this morning. It went dormant without treatment if i am recalling correctly? The doctors back then thought it was lukemia for a short period before figuring out it was TTP. Scary stuff thanks for the laugh!
@@MedicosisPerfectionalis Thank you for making the video! We have our heme/onc/cardio/renal/pulm exam coming up (yes, our deans did that 🤪) and I am about to be the biggest fan of the heme/onc playlist!!
Hhhh as you educating others as well as you bringing smile 🙂🙂😁 also the way you are teaching wooooww and you also making question from yourself and answering too
@@MedicosisPerfectionalis i was my assignment and watching many videos but at least I found it at your channel and hence completed my assignment 🙂🙂☺️ love you
Brahmi Chyawanprash for planet Ayurveda It supports almost all systems of the body. It is a purely natural product and does not contain binders, preservatives, additives, yeast, and fillers in it.
@@Moosemoose1 I asked myself the same question and the answer is that ITP is a no platelet thing but TTP is crazy platelets the forms thrombosis every where causeing micro angiopathic hemolysis of r.b.cs and stuff like that
Due to the deposition of microthrombi in the small vessels, the lumen becomes narrower. RBCs try to squeeze through the narrowed lumen....and it goes boom
Thrombocytopenia is too nonspecific, it is present in HELLP and DIC. The last two criteria (fever & mental status changes) do not work for HUS, only for TTP...
Love the Gordon Ramsay monologue at the end 🤣
Coombs test is negative because although the IgG antibodies are present, they are not against RBC's or platelets, they are against the enzyme which breaks down vWF.
Wow loved how you explain everything in details and you repeat the important things more than 1 time.
You made medicine super fun whilst givin proper info. Thanks . Subbed!
Thank you 🙏
The unique and funny way of explaining stuff and the way tough topics are broken down into easy and digestible bits are a boon to have, before exams.
Keep up God's work good sir!! Left you a like❤
Plasmapharesis BABY!!!
OMG I love this so much! thank you. i just started working in hematology after working for years in onco and ITU. I was having a hard time making patterns and organizing my studies. this extremely helps! thank you!!!!!
You're so welcome!
Would you please help me by sharing?
currently an img studying for my step 1 and this video gave me a much clearer understanding of TTP!
I am glad it helped!
Please help me by sharing my videos with others.
the gordon ramsay bit: excellent!!
Hehe
I was diagnosed with TTP a couple of weeks ago. Still in the hospital, but PEX got things in order (the last one was three days ago). This video was extremely helpful and helped me understand what's happening to me. Thank you!
Btw, they suspect I might actually be one of those extremely rare cases of inherited TTP. Gotta start buying lottery tickets 😂
Update: ADAMTS13 Inhibitor test came back positive so at least I was getting the right treatment. And it has been working. ADAMTS13 activity is in the normal range (0.41) and platelet count has stabilized in the lower end of the normal range. So far so good!
What are ur symptoms?
@@salamsthoughts5842 couple of bruises on the legs, a bit of confusion, and petechiae (both legs). I was feeling unwell for a few days before all of these symptoms appeared.
@@salamsthoughts5842 everything has been normal after the treatment. Platelets normalized around 160 (even though they dropped to 130 for a couple of weeks) and ADAMTS13 activity has been between 0.48 and 0.79 (doing the test every month).
@@PedramV get well bro❤
9:59 "i dont care nerd" will now be my response when the attending trys to pimp me
love the energy you're bringing hahah
Thank you ☺️
I currently have ttp but I’m fighting I will get through this !!
Stay strong!
Ahh this was so much fun. Where was this channel all my life!,
Data - information- knowledge- wisdom great bro💥💥💥💯💯❤️
Thank you ☺️
The Rolls-Royce of medicine indeed. 🩸
Thank you, Sir!
Wow really you're all material is very conceptual,thanks sir keep it up,be happy and healthy forever
Thank you so much 😊
Mo Salah of medicine 🔝🔝
Thank you ☺️
Very well explain which helps to memorise clear concepts for exam preparation ❤keep it up bro💯👍🙏
I love you man u literally saving my life .
I thought i will watch the pathology of TTP only and skip the rest video…but crap i got Stuck 😂😂😂
Your videos are extremely helpful n fun to watch. 🙂
Thank you 🙏
Great video! Unlike many professors you explain in a clear and simple way!
In this regard, I was told that in TTP, unlike DIC, there is no hemorrhagic risk and the purpura is due to blood extravasation following endothelial damage due to ischemia caused by the formation of microthrombi.
But i was wondering...Isn't poropra a result of thrombocytopenia? Furthermore, shouldn't thrombocytopenia (
Great question!
There might be a hemorrhagic risk, but it really depends on how low the platelet count. A person with a platelet count of 4,000 is a completely different story than a patient with a platelet count of 48,000. Also, we have to take the coagulation factors into consideration. Platelets usually protect us from superficial bleeding, whereas the coagulation factors protect us from deep tissue bleeding (e.g. internal bleeding).
Hope that helps!
Keep it up ❤❤
But why is the quality so bad 😢
Genius Simplifying Work ✅✅✅✅
I have 2 boys and now my baby girl husband and I are carriers..... But no matter what science says nothing is impossible for God Doctors are always surprise how my boy body react prayers are so powerful never stop believing God is amazing and always can do miracle's TTP🔗chain breakers Philippians 4:13🙏❤ thank you Dr beautiful explained
Amin
Hello, doctor
I have one question. In TTP , vWf is overly active,platelets are adhered to form a thrombosis and the number of circulated free platelets decrease. In Bernard Soulier disease vWf is normal but receptor is inactive. It doesn't adhere to form thrombosis. So,they should be circulated freely through the bloodstream .But why ,platelet number decrease instead of increasing ?
Great question! From my understanding, lack of GP1b also leads to the platelets being abnormally shaped in Bernard-Soulier syndrome (i.e. "Giant platelet cells") and, as you mentioned, since they are freely circulating in the bloodstream due to lack the ability for adhesion, they are also subject to shearing forces, leading to further shape irregularities. This, combined with their increased freely circulating quantity leads to detection by the immune system and hence the their destruction and clearance by the immune system.
This is medicosis, the Rolls Royce of medicine 😂❤
Wow, I wish to be amazing like this medicosis guy superb🎉
Thank you so much!
Hello, I just got out of the hospital after a bought with TTP. Luckily I caught it in time before it took me. I’m 44 years old. My blood counts are normal. I had about 6 sessions of plasmapheresis. Its now my second night back at home after discharge, and at night I tend to shake a little bit when lying down. Is this just my body slowly accommodating to the plasmapheresis process? I’m also on prednisone. Thank you so much.
Nicely explained.Since TTP is intravascular hemolysis,then why splenomegaly in it?Pls answer
To increase the plt count. This is no longer applicable.
Im pretty sure its because you are getting Schistocytes from the platelet microthrombi that is being formed in TTP. Its shearing the rbcs as they come along and so now that they are effected/damaged, the spleen filters them out which causes the spleen to overwork leading to work induced hyperplasia. i.e. splenomegaly.
Or it could be what SixthKiller is saying and just extramedullary hematopoesis occurring due to the loss of platelets but i dont rlly believe that since there is no hepatomegaly.
Where do the neurologic symptoms and fever come from? I have watched the video carefully and loved it, but I don't really get the reasons for these additional symptoms
It’s a systemic pathophysiological process that can affect anything. Statistically, some symptoms are more common than others, but I don’t know why.
Neurological symptoms due to microembolic occlusion probably
Just yesterday I saw a case of TTP from a dog bite. It escalated to sepsis and internal bleeding...the lab results and images all indicate an aquired TTP. Really interesting.
amazing!
thank you.. I loved it .. but if you could please speak much more slowly.. I'm getting lost sometimes 🥺
change the playback speed to 0.75!
Awkward Im over here wishing 3x speed was as option 😂😂😂.
amazing videos. Do you talk on histopathology topics?
Unfortunately, not yet!
my new fav channel ;)
Thank you so much 😊
Glad I've come to know you
Thank you!
I am honored!
This guy is funny and very good !!!
Thank you so much 😊
☺️☺️
Fever and neurological symptoms(AMS)
9:56 😂 I had this aquired ttp as a kid about 20 yr ago just wanted to understand it a bit better for some reason this morning. It went dormant without treatment if i am recalling correctly? The doctors back then thought it was lukemia for a short period before figuring out it was TTP. Scary stuff thanks for the laugh!
"you need to know what the flip you are talking about" hahaha fortunately that is the reason I am here good sir
Thank you so much for watching 😊
@@MedicosisPerfectionalis Thank you for making the video! We have our heme/onc/cardio/renal/pulm exam coming up (yes, our deans did that 🤪) and I am about to be the biggest fan of the heme/onc playlist!!
Good luck 🍀 to you, dear :)
thank u, helpful video
BTW in university, we were taught that schistocytes could never be an artifacts
Keep up the great work
Hhhh as you educating others as well as you bringing smile 🙂🙂😁 also the way you are teaching wooooww and you also making question from yourself and answering too
Thank you 😊
@@MedicosisPerfectionalis i was my assignment and watching many videos but at least I found it at your channel and hence completed my assignment 🙂🙂☺️ love you
nice information
Loved it thank u so much 💖
My pleasure 😇
OMG I was so going "its 76 to 100" on the MCV😂😂
Amazing video 🙏🏻
Thank you 🙏
Brahmi Chyawanprash for planet Ayurveda It supports almost all systems of the body. It is a purely natural product and does not contain binders, preservatives, additives, yeast, and fillers in it.
You are amazing thank you so much ☘️🙏🏻
Wonderful and excellent thank you doctor
Medicosis - The Rolls-Royce of Medicine
he cracks me up
Thank you 😊
Loved it, thanks!
My pleasure 😇
Amazing Keep up journey
I want to know how you make such videos. Writing and making pictures too. always explained best.
Excellent. Thank you.
My pleasure 😇
Amazing vedio 🌹
Thank you 🙏
Fantastic man!
Excellent
Thank you 🙏
I'm waiting for your explanation about DIC 😁😁
Coming soon
What's with the purple cat at the end?
Amazing 😍😍
marvellous...thank you
Why fever occurs in ttp plz explain
Excellent!!!!!!
Thanks 🙏
178 O'Keefe Prairie
Vandervort Summit
I have a question: if the inhibitor of the ADAMST13 gene is IgG, why isn't TTP considered an immune disorder?
It is actually considered immune disorder and ttt is prednisone for that cause
@@ahmedrashwan7250 ah, then what would differentiate it from ITP in that case?
@@Moosemoose1 I asked myself the same question and the answer is that ITP is a no platelet thing but TTP is crazy platelets the forms thrombosis every where causeing micro angiopathic hemolysis of r.b.cs and stuff like that
Great 👍
Thank you!
Would you please help me by sharing?
Ernestina Groves
it was very scary this is sierous
The FFP joke is elite 😂😂😂😂😂😂omg
My brother is in hospital with this he is only 12 please give me hope
I'm 29 I had it when I was younger than your brother
It rarely even crosses my mind this many years later
hi do you have document for these?
Hey 👋 Belle,
How are you?
What do you mean by “document”?
Why there is hemolysis i could not get it. Plz help
Due to the deposition of microthrombi in the small vessels, the lumen becomes narrower. RBCs try to squeeze through the narrowed lumen....and it goes boom
Fever and no bloody diarrhea !
Wonderful!!!!!
Thank you 🙏
5:25
Ribozyme is not a protien I guess
There is no fever
Upshaw Schulman syndrome. Very difficult name for Bengali
Rolce Roy's medicine
😊😊😊
2563 Krystel Mount
Why is there a fever in TTP?
I have TTP. 7 episodes. Not a single fever.
Never had a fever either.
1 episode...super severe though
I am with ttp and I had a massive sweating all the time. Today was my second plasmapheresis.
My baby 5 manth old TTP
I don’t get the answer ☹️☹️
AKI + Thrombocytopenia? 😕
Yuppp I’ve already watched the next video
It’s MAHA + thrombocytopenia 🤭
Here bc J Dilla died from this
So funny ..thank you ❤️
LOL! The Rolls Royce of Medicine
😂😂 It’s true 😊😊
Hello telugu lo explain chIagalaru
Perez Patricia Lee Sandra Lee Barbara
you are so fast slow down a bit
Got it...Thanks!
My mom died from this
I am so sorry!
Gr8
Thank you!
Tehrik-i-Taliban Pakistan is TTP
Can u make an Arabic translate for your videos?
I would love to, but it will take so much time.
Sorry!
Young Patricia Harris Frank Lewis Matthew
Young Susan Robinson George Perez Kenneth
You're goated 😂
What does that mean?! 😅
AKI & MAHA?🙈
Nope
😁How come?!
Thrombocytopenia is too nonspecific, it is present in HELLP and DIC. The last two criteria (fever & mental status changes) do not work for HUS, only for TTP...
Hello, your teaching is really nice but you talk really fast it would be nice to tone down your pace. Thank you
❤
Slow down with explanation