pearljam59
Forum Guru
Topics: 120
Posts: 273
|
A 72-year-old man comes to the emergency department because of a 2-hour episode of loss of vision in the leR eye. He has never smoked.
Laboratoty studies show:
Hemoglobin 20 g/dL
Hematocrit 62%
Leukocyte count 14,200/mm3
Differential normal
Mean corpuscular volume 87.2 /m3
Platelet count 375,000/mm3
Which of the following is the most appropriate initial therapy?
A) Admlnlstratlon of allopurlnol
B) Administration of asoirin
C) Administration of chiorambucil
D) Administration of hydrowurea
E) Admlnlstratlon of warfarin
F) Phlebotomy
G) Splenectomy
|
| yasmeen
Forum Guru
Topics: 67
Posts: 936
|
ok its polycythemia rubravera so its either f or d but i,m inclined towards f.
|
| robin082006
Forum Hero
Topics: 471
Posts: 5,125
|
F
___________________
The Key to Succeed is Patience.
|
| tolito
Forum Fanatic
Topics: 119
Posts: 2,162
|
F.
___________________
It has been a looooong hard journey but I am inches away from my destination...
|
| macintosh
Forum Elite
Topics: 38
Posts: 178
|
Agree with F, but who will post the correct answer?
|
| hottie99
Forum Elite
Topics: 30
Posts: 553
|
no one can post official answer, it's on nbme form, but if it looks like f, and seems like f, then most likely it's... F 
Edited by hottie99 on 04/04/08 - 10:59 PM
|
| macintosh
Forum Elite
Topics: 38
Posts: 178
|
Ok I want to be really sure why we are not using Aspirin. Is it the normal platelet count (N = 150,000-400,000)?
|
| hottie99
Forum Elite
Topics: 30
Posts: 553
|
yeah i did the same mistake when i took the nbme, i thought he had a stroke, so i put give ASA, but his hematocrit is off the charts, indicating polycythemia, and the treatment for that is phlebotomy. ASA wont decrease it that fast as will phlebotomy, and yes his platelets are within normal range, we're treating to reduce hct, not the platelet count
|
| macintosh
Forum Elite
Topics: 38
Posts: 178
|
But what should be the answer if he had both an increased Hct and an increased platelet count?
|
| milee99
Forum Guru
Topics: 36
Posts: 781
|
hi
asa will not decrease platelet count ,it will only cause functional platelet dysfunction.
Merely increased platelet count does not cause aggregation of platelets .. if there is a platelet plug/thrombus over there ,it will be formed due to an initial injury to endothelium / activation of coagulation . In that case , there would be a thrombus even if the platelet count was normal.
phlebotomy will treat both increased platelet count and erythocyte count
___________________
Do not pray for easy lives,Pray to be stronger men; Do not pray for tasks equal to your powers, Pray for powers equal to your tasks; Then the doing of your work shall be no miracle, but you shall be the miracle.
|
|
| |
| | | | | | | | | | |
