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I am easy - jumpingjack - Printable Version +- USMLE Forum - Largest USMLE Community (https://www.usmleforum.com) +-- Forum: USMLE Forum (https://www.usmleforum.com/forumdisplay.php?fid=1) +--- Forum: Step 1 (https://www.usmleforum.com/forumdisplay.php?fid=2) +--- Thread: I am easy - jumpingjack (/showthread.php?tid=176007) |
I am easy - jumpingjack - ArchivalUser - 04-03-2007 A 58-year-old woman is having persistent heavy bleeding from her surgical wound following a mastectomy for carcinoma of breast. Purpura of her arms and truck are noted. Urine output has been only 300 mL in 24 hours. Laboratory studies show hemoglobin 9 gm/dL, white blood cells 16,500/mm3, with 75% polymorphonuclear leukocytes and 12% bands, and platelets 55,000/mm3. Serum urea nitrogen (BUN) is 35 mg/dL, creatinine is 2.8 mg/dL. Coagulation studies reveal a prothrombin time of 18 seconds and an activated partial thromboplastin time of 50 seconds. Fibrinogen is 150 mg/dL, thrombin time is prolonged, fibrin degradation products are 30 micrograms/dL (normal <10), D-Dimer is 600 micrograms/L (normal <250). Urinalysis shows numerous red cells in the sediment. Which of the following is the most likely diagnosis? (A) Disseminated intravascular coagulation (DIC) (B) Dysfibrinogenemia © Hemolytic uremic syndrome (D) Idiopathic thrombocytopenic purpura (ITP) (E) Inadequate surgical hemostasis, with consumption of clotting factors due to hemorrhage 0 - ArchivalUser - 04-03-2007 aa 0 - ArchivalUser - 04-03-2007 a? 0 - ArchivalUser - 04-03-2007 a or c.. no sure 0 - ArchivalUser - 04-03-2007 aa 0 - ArchivalUser - 04-03-2007 The answer is A (DIC) 0 - ArchivalUser - 04-03-2007 D-dimers and fibrin degaradation products are the clue words in this question. Obviously the answer is A (DIC) 0 - ArchivalUser - 04-04-2007 yes the ans is aaa,good job |