01-03-2015, 03:48 PM
Rosy, a 16 y/o girl is brought by her mother because she is having menses for 10-12 days for the past 6 months. She is concerned because of her brother has some blood disease and he needed several blood transfusions after a cholecystectomy. The pt is otherwise healthy and denies any smoking or alcohol use. Her vitals are temp 98.3F, BP 125/78 mmHg, PR 89/min, RR 18/min. There is a marked pallor under the mucous membranes. Blood work along with coagulation profile is ordered and results are:
WBC..................8600
HB.....................9.0
Hct....................26%
Platelets.............96000
Bleeding Time.....8 min
PT......................12.1 sec
PTT.....................30 sec
Giant platelets are seen on the peripheral smear.Looking at the bleeding time the physician asks qualitative platelets tests, which showes
platelet aggregation studies with ADP.............Normal
platelet aggregation studies with Ristocetin.....Subnormal
vWF............................................................Normal
What is the most probable Dx?
A-Thrombotic Thrombocytopenic purpura
B-vWF disease
C-Idiopathic Thrombocytopenic purpura
D-Glanzmann's Thrombasthenia
E-Chediak-Higashi syndrome
F-Bernard-Soulier syndrome
WBC..................8600
HB.....................9.0
Hct....................26%
Platelets.............96000
Bleeding Time.....8 min
PT......................12.1 sec
PTT.....................30 sec
Giant platelets are seen on the peripheral smear.Looking at the bleeding time the physician asks qualitative platelets tests, which showes
platelet aggregation studies with ADP.............Normal
platelet aggregation studies with Ristocetin.....Subnormal
vWF............................................................Normal
What is the most probable Dx?
A-Thrombotic Thrombocytopenic purpura
B-vWF disease
C-Idiopathic Thrombocytopenic purpura
D-Glanzmann's Thrombasthenia
E-Chediak-Higashi syndrome
F-Bernard-Soulier syndrome