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NBME 17 Answers

nbme17/Block 0/Question#0 (reveal difficulty score)
A 27-year-old primigravid woman at 34 weeks' ...
Schistocytes ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1780)
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This woman is showing signs of HELLP syndrome (Hemolysis, elevated liver enzymes, low platelets) [FA2020 p643] HELLP can lead to DIC.

A blood smear will show schistocytes.

HELLP syndrome is a manifestation of severe preeclamspia (hypertension after 20 weeks with either proteinuria or end-organ dysfunction).

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imgdoc  EVERY TIME THERE IS A PREGNANT LADY WITH HYPERTENSION AFTER 20 WEEKS GESTATION YOU SHOULD IMMEDIATELY BE THINKING PREECLAMPSIA and ALL ITS COMPLICATIONS. Sorry for all caps, but I've gotten so many preeclampsia questions wrong, and because of it, I'll never miss another one! Hopefully this helps you guys clue into Preeclampsia -> HELLP. +
kevinsinghkang  Why is it not spherocytes? I thought hemolytic anemia---> spherocytes? +1
thatmd  @kevinsinghkhan AIHA=Spherocytes VS MAHA=Schistocytes FA 2020pg 423 +



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