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  #1  
Old 08-13-2012
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Default UWorld Step 1 Question.

A 37-year-old woman who has a clinical picture of fever, splenomegaly, varying neurologic manifestations, and purplish ecchymoses of the skin is found to have a hemoglobin level of 10.0 g/dL, a mean corpuscular hemoglobin concentration (MCHC) of 48, peripheral blood polychromasia with stippled macrocytes, and spherocytes, with a blood urea nitrogen level of 68 mg/dL. The findings of coagulation studies and the patientís fibrin-degraded products are not overtly abnormal. Which of the following is most closely identified with these findings

A.Idiopathic thrombocytopenic purpura
B.Thrombotic thrombocytopenic purpura
C.Disseminated intravascular coagulopathy
D.Submassive hepatic necrosis
E.Waterhouse-Friderichsen syndrome
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  #2  
Old 08-13-2012
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Originally Posted by lawsonbenjamin View Post
A 37-year-old woman who has a clinical picture of fever, splenomegaly, varying neurologic manifestations, and purplish ecchymoses of the skin is found to have a hemoglobin level of 10.0 g/dL, a mean corpuscular hemoglobin concentration (MCHC) of 48, peripheral blood polychromasia with stippled macrocytes, and spherocytes, with a blood urea nitrogen level of 68 mg/dL. The findings of coagulation studies and the patient’s fibrin-degraded products are not overtly abnormal. Which of the following is most closely identified with these findings

A.Idiopathic thrombocytopenic purpura
B.Thrombotic thrombocytopenic purpura
C.Disseminated intravascular coagulopathy
D.Submassive hepatic necrosis
E.Waterhouse-Friderichsen syndrome
edit
I think its B.

Last edited by Step-step; 08-13-2012 at 06:16 PM.
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Old 08-13-2012
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I think its A.
pls explain ur answer
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Old 08-13-2012
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pls explain ur answer
sorry, i think its Thrombotic Thrombocytopenic purpura... given the blood smear abnormalities, the neuro symptoms and renal dysfunction.
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Old 08-13-2012
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Originally Posted by lawsonbenjamin View Post
A 37-year-old woman who has a clinical picture of fever, splenomegaly, varying neurologic manifestations, and purplish ecchymoses of the skin is found to have a hemoglobin level of 10.0 g/dL, a mean corpuscular hemoglobin concentration (MCHC) of 48, peripheral blood polychromasia with stippled macrocytes, and spherocytes, with a blood urea nitrogen level of 68 mg/dL. The findings of coagulation studies and the patientís fibrin-degraded products are not overtly abnormal. Which of the following is most closely identified with these findings

A.Idiopathic thrombocytopenic purpura
B.Thrombotic thrombocytopenic purpura
C.Disseminated intravascular coagulopathy
D.Submassive hepatic necrosis
E.Waterhouse-Friderichsen syndrome
Renal involvement makes the answer B
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Old 08-13-2012
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Originally Posted by lawsonbenjamin View Post
pls explain ur answer
Bb...pentad of TTP(fever,microangiopathic hemolysis,thrombocytopenia,neurologic & renal symptoms)
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