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Old 04-04-2012
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Question Thrombocytopnic Rash; Next step?

A 44-year-old female presents to the emergency room complaining of a rash on her legs and arms that appeared the previous day. She denies any recent new foods or clothes. She takes no medications and feels well although she had a ”head cold” 2 weeks ago that passed uneventfully. On exam she has an extensive 1 to 2 mm nonblanching rash that is not raised above the natural skin plane on her arms, legs, and the roof of her mouth. Her laboratory studies reveal hemoglobin of 12 g/dL, platelet count of 12,000/mm2, and a normal international normalized ratio. What is the most appropriate first line therapy for this patient?

A. Blood transfusion
B. Fresh frozen plasma
C. Intravenous steroids
D. Platelets
E. Splenectomy
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Old 04-04-2012
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ans. C, its ITP, post viral infection, no blood transfusion Hb norma, no FFP INR normal, platelts will further worse condition, its 1st time pt presentation so no need of splenectomy, and this pt platelets count less then 50000, uw say less then 30000 give steriod.
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Old 04-04-2012
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c) steroids
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Old 04-04-2012
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Check the table on pg 233 in MTB 2CK. It'll solve the doubt
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