Deck 40: Thrombocytopenia and Thrombocytosis

Question 1

Which of the following is successfully treated with plasmapheresis?

A)immune thrombocytopenic purpura
B)chronic DIC
C)acute DIC
D)thrombotic thrombocytopenic purpura

Answer 1

thrombotic thrombocytopenic purpura

Question 2

A 4-year-old child becomes very sick after eating undercooked ground beef.Kidney function tests are very elevated.Thrombocytopenia is mild,and a few schistocytes are noted on the blood film.Which of the following is most likely diagnosis?

A)immune thrombocytopenic purpura
B)thrombotic thrombocytopenic purpura
C)hemolytic uremic syndrome
D)DIC

Answer 2

hemolytic uremic syndrome

Question 3

A 35-year-old woman with neurologic symptoms presents with a markedly decreased platelet count.She has moderate anemia with many red cell fragments on the blood film,as well as polychromasia and nucleated red blood cells (RBCs).The prothrombin time (PT)and partial thromboplastin time (PTT)are both normal.Which of the following is most likely diagnosis?

A)immune thrombocytopenic purpura
B)thrombotic thrombocytopenic purpura
C)hemolytic uremic syndrome
D)DIC

Answer 3

thrombotic thrombocytopenic purpura

Question 4

What tests are best to distinguish thrombotic thrombocytopenic purpura from DIC when a patient has schistocytes?

A)platelet count and morphology
B)bone marrow aspirate and biopsy
C)reticulocyte count and haptoglobin
D)PT and PTT

Question 5

A 28-year-old woman sees her family physician complaining of easy bruising and menorrhagia.She has a platelet count of 60 * 10⁹/L.All other hematology and routine coagulation tests are normal.She has a platelet-associated immunoglobulin G (IgG)autoantibody in her serum.Which of the following is most likely?

A)chronic immune thrombocytopenic purpura
B)thrombotic thrombocytopenic purpura
C)acute immune thrombocytopenic purpura
D)hemolytic uremic syndrome

Question 6

What is the correct term to describe a platelet count of 550 * 10⁹/L when all other complete blood count (CBC)results are basically normal?

A)normal
B)thrombocytosis
C)thrombocytopenia
D)essential thrombocythemia

Question 7

What kind of antibody causes neonatal alloimmune thrombocytopenia?

A)maternal antibody against a fetal platelet antigen inherited from the father
B)fetal antibody directed against maternal platelet antigen
C)fetal antibody against a fetal platelet antigen inherited from the father
D)maternal autoantibody against a mother's platelet antigen

Question 8

A patient has a platelet count of 650 * 10⁹/L.The other hematology tests are normal.No evidence of hemostasis failure exists.Which of the following is most likely?

A)reactive thrombocytosis
B)essential thrombocythemia
C)DIC
D)polycythemia vera

Question 9

A patient in the intensive care unit has anemia,schistocytes,and thrombocytopenia.The PT and PTT are elevated,and the fibrinogen is low.What test to confirm what diagnosis would be appropriate?

A)D dimer to confirm acute DIC
B)bone marrow to confirm immune thrombocytopenic purpura
C)platelet antibody against P1A1 to confirm heparin-induced thrombocytopenia
D)platelet aggregometry to confirm posttransfusion purpura

Question 10

Which of the following patient groups is most commonly diagnosed with acute immune thrombocytopenic purpura?

A)older men after an infection
B)infants born to women who had eclampsia
C)children after having an infection
D)adult patients with enlarged spleens

Question 11

A 23-year-old man is brought by helicopter to a major trauma center after a severe motorcycle accident.He has major abdominal trauma,including a ruptured spleen,and is taken to surgery,where his spleen is removed.Two weeks after surgery,his platelet count peaks at 950 * 10⁹/L.What is the most likely cause for this high platelet count?

A)reactive thrombocytosis secondary to trauma
B)essential thrombocythemia
C)postsplenectomy thrombocytosis
D)reactive thrombocytosis secondary to acute blood loss

Question 12

All of the following are often associated with thrombocytosis except

A)hemorrhage
B)alcoholic liver disease
C)iron deficiency
D)inflammation

Question 13

What is believed to be the cause for acute immune thrombocytopenia purpura in children?

A)development of a platelet-specific autoantibody
B)development of a white cell autoantibody that cross-reacts with platelet membrane antigens
C)development of an allogeneic antibody after transfusion of random allogeneic platelets
D)nonspecific binding of immune complexes to the platelet membrane after a viral illness

Question 14

What is the single most common cause of clinically important bleeding?

A)hemophilia
B)fibrinogen deficiency
C)thrombocytopenia
D)qualitative platelet disorders

Question 15

Which of the following results in ineffective thrombopoiesis?

A)immune thrombocytopenic purpura
B)thrombotic thrombocytopenic purpura
C)disseminated intravascular coagulation (DIC)
D)megaloblastic anemia

Question 16

Which of the following is an example of a quantitative platelet disorder related to distribution?

A)thrombotic cytopenic purpura
B)essential thrombocythemia
C)splenomegaly
D)hemolytic uremic syndrome

Question 17

Chemotherapy results in which of the following?

A)acquired hypoplastic thrombocytopenia
B)acquired immune thrombocytopenia
C)acquired splenic sequestration
D)inherited nonimmune thrombocythemia

Question 18

The terms petechiae,purpura,and ecchymoses all describe

A)varying degrees of thrombocytopenia.
B)varying degrees of thrombocythemia.
C)varying qualitative platelet disorders.
D)varying size hemorrhages into the skin because of small-vessel bleeding.

Question 19

What is the most common infectious cause of congenital neonatal megakaryocytic hypoplasia?

A)Epstein-Barr virus
B)human immunodeficiency virus (HIV)
C)cytomegalovirus
D)rubella

Question 20

Which of the following is a commonly used drug that can cause thrombocytopenia?

A)warfarin
B)aspirin
C)ibuprofen
D)heparin

Question 21

What is the most serious clinical consequence of heparin-induced thrombocytopenia?

A)hemorrhage
B)thrombosis
C)factor XII activation
D)resistance to aspirin therapy

Question 22

What are the primary clinical manifestations of essential thrombocythemia?

A)platelet dysfunction
B)hemorrhage
C)thrombosis
D)all of the above

Question 23

What is the probable cause for thrombotic thrombocytopenic purpura?

A)deficiency of a metalloprotease needed to enzymatically degrade unusually large von Willebrand factor (VWF) multimers
B)abnormal synthesis of unusually large VWF multimers by endothelial cells
C)abnormal synthesis of unusually large VWF multimers by megakaryocytes
D)abnormal complexing of normal VWF multimers to create unusually large VWF multimers

Question 24

An enzyme-linked immunosorbent assay (ELISA)with platelet factor 4 (PF4)coated to the surface of microplate wells is used for the diagnosis of

A)heparin-induced thrombocytopenia.
B)acute immune thrombocytopenic purpura.
C)chronic immune thrombocytopenic purpura.
D)aspirin resistance.