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Old 09-07-2012
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Default Nbme 3 : B1 q1

(I'm doing the NBME offline. Can someone please explain this question/answer - it says the answer is A)

A 12-year-old girl with chronic renal failure has had persistent epistaxis for 15 days. Laboratory studies show:

Hemoglobin 7.2 g/dL
Platelet count 175,000/mm3
Bleeding time 12 min
Prothrombin time 12 sec
Partial thromboplastin time (activated) 30 sec
Serum urea nitrogen (BUN) 125 mg/dL

Which of the following is the most likely cause of the epistaxis?
A) Acquired platelet dysfunction
B) Circulating immune complexes
C) Erythropoietin deficiency
D) Factor III deficiency
E) Hypocalcemia
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  #2  
Old 09-07-2012
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Uremia in CRF patients is the cause of this platelets dysfunction.
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Old 09-07-2012
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Default its a qualitative primary platelet disfuntion

uremia from renal pathology disrupts platelet function,it impairs both aggregation and adhesion.
the lab values except BT are normal in qualitative primary dysfn.as seen in this patient.
can also be caused by aspirin


A 12-year-old girl with chronic renal failure has had persistent epistaxis for 15 days. Laboratory studies show:

Hemoglobin 7.2 g/dL
Platelet count 175,000/mm3
Bleeding time 12 min
Prothrombin time 12 sec
Partial thromboplastin time (activated) 30 sec
Serum urea nitrogen (BUN) 125 mg/dL

Which of the following is the most likely cause of the epistaxis?
A) Acquired platelet dysfunction
B) Circulating immune complexes
C) Erythropoietin deficiency
D) Factor III deficiency
E) Hypocalcemia[/QUOTE]
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Old 09-07-2012
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Default

Quote:
Originally Posted by sam2021 View Post
(I'm doing the NBME offline. Can someone please explain this question/answer - it says the answer is A)

A 12-year-old girl with chronic renal failure has had persistent epistaxis for 15 days. Laboratory studies show:

Hemoglobin 7.2 g/dL
Platelet count 175,000/mm3
Bleeding time 12 min
Prothrombin time 12 sec
Partial thromboplastin time (activated) 30 sec
Serum urea nitrogen (BUN) 125 mg/dL

Which of the following is the most likely cause of the epistaxis?
A) Acquired platelet dysfunction
B) Circulating immune complexes
C) Erythropoietin deficiency
D) Factor III deficiency
E) Hypocalcemia

uremia causes platelet dysfunction
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