drfax
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A 42 yr old woman has had nosebleeds, easy bruising, and increased bleeding with her mestrual periodis for the past 4 months. On physical exam. , her temp. is 37 C, pulse 88/min, respirations 18/min, BP 90?60 mm Hg. she has scattered petechiae over the distal extremities. There is no organomegaly. Lab. studies show hemoglobin of 12.3 g/dL, hematocrit 37.0%, platelet count 21,500/cc, and WBC count 7370/cc. A bone marrow biopsy specimen shows a marked increase in megakaryocytes. The PT and PTT are normal , which of the following is most likely diagnosis ?
A.DIC
B.Hemophilia B
C.Idiopathic Thrombocytopenic purpura
D.Metastatic breast CA
E.Thrombotic thrombocytopenic purpura
F.vit. K defeciency
G.Von Willebrand disease
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| dreamer
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c
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| fox
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c
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| ManuNastai
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yup.. C
thread extention: how do you differentiate ITP from TTP and Hemolytic Uremic Syndrome and what do they have in common?
I've done a Q last night and I eliminated every one except TTP and HUS. they said the fibrin split products were normal so I eliminated TTP, but seemed I was wrong.. why?
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| drfax
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HI manunasti
TTP has a pentad of fever, thrombocytopenia, renal failure, autoimmune hemolytic anemia with presence of schistocyte, and neurological deficit, but in ITP these are not present
HUS is caused by E.Coli (most commonly), and present with dark urine
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| ManuNastai
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...what about in terms of labs? how do i do the differential?
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| drfax
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They are the same in term of lab. values, b coz they are platelet disorders with different presentation ,
history and clinical presentation is important here,
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