05-23-2008, 09:50 AM
A 25-year-old female, with previous history of easy bruising, presents with menorrhagia. Previously, she was investigated for endocrine disorders but the only abnormality found was low platelet count. A diagnosis of idiopathic thrombocytopenia was made. She has not been taking any medications. She smokes 1pack/day cigarettes for the last 5 years and drinks alcohol, only on social occasions. She is in a monogamous relation with her husband. She does not have a family history of any bleeding (hematological) disorder. Her vitals are, PR: 76/min; RR: 16/min; BP: 115/76 mm of Hg; Temperature: 37C(98.6F). Petechiae are the only abnormality found on her examination. There is no lymphadenopathy or hepatosplenomegaly.
Lab tests show:
Hematocrit 40%
WBC count 11,000/micro-L
Platelet count 19,000/miro-L.
Peripheral blood smear shows large platelets. Prothrombin time and partial thromboplastin times are normal while bleeding time is increased. Bone marrow biopsy is performed which shows increased number of megakaryocytes. Which of the following additional testing should be considered as part of work-up in this patient?
A. Antinuclear antibody testing
B. Liver function tests
C. Chest X-ray
D. ELISA testing for HIV
E. Factor VIII assay
F. Monospot test
Lab tests show:
Hematocrit 40%
WBC count 11,000/micro-L
Platelet count 19,000/miro-L.
Peripheral blood smear shows large platelets. Prothrombin time and partial thromboplastin times are normal while bleeding time is increased. Bone marrow biopsy is performed which shows increased number of megakaryocytes. Which of the following additional testing should be considered as part of work-up in this patient?
A. Antinuclear antibody testing
B. Liver function tests
C. Chest X-ray
D. ELISA testing for HIV
E. Factor VIII assay
F. Monospot test