sheeezooo
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27y/o f comes to E/D with headache and fever.she dont have history of recent infection and any drug exposure.medical history unremarkable.on exam pt appears lethargic.
temp..100.5f, pulse 100/min, BP 130/85mmhg,
respirations are 18/min,her conjuctiva is yellowish, and scattered petechie are noted on the lower extremities,liver and spleen are not enlarged. lab shows..wbc12,000/mm3,hematocrit27%,platelets...14,000/mm3,bilirubin 4.5mg/dl,direct biirubin 0.5mg/dl; BUN 40 mg/dl..creatinine 3.5mg/dl, PT,PTT,fibrinogen all r normal.her peripheral smear shows fragmented red blood cells..
what is most effective treatment of this pt..
a.splenectomy
b.glucocorticoids
c.plasmaphresis
d.I/V immunoglobulins
e.platelet transfusion
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| saadtazjam
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A????
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| sheeezooo
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saadtazjam.. see the other q will be back tommorrow..for the ans..
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| robin082006
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this is TTP
I go with C
but still wonder about A
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| Guptashutosh
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ans; diag-TTP, (E)
D/D: ITP, also common in fem... diff features here:normal spleen, Normal creat, peripheral smear normal, T/t for itp glucocorticoids....
i wish i m correct, wat do u say sheezooo ... wats the corect ans
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| Guptashutosh
Forum Elite
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i chose E becoz with such a low platlet plasma pharesis is risky, we need to corrct plt count first
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| sheeezooo
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she has TTP..can u give the platelet transfusion in this pt??
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if u hold up your head with a smile on your face and are truely thankful,u are blessed because the majority can, but most do not..
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| Guptashutosh
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yes plasmapheresis is the ans, thx sheezoo
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