NBME 22 Immune thrombocytopenic purpura (NBME Answers)

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Retired NBME 22 Answers

nbme22/Block 1/Question#47 (reveal difficulty score)
A 25-year-old woman comes to the physician ...
Immune thrombocytopenic purpura 🔍 / 📺 / 🌳 / 📖
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submitted by ∗drmohandes(193)

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DIC, unlikely: PT/PTT normal; wouldn't just see gum bleeding
hypersplenism: would cause anemia
iron deficiency: anemia
vitamin C deficiency: wouldn't cause thrombocytopenia
von Willebrand disease: mixed platelet/coagulation disorder → would cause deep joint bleeding instead of mucosal membrane bleeding. Inherited (Autosomal Dominant), would see symptoms before. PTT can be normal/high.

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beto Bleeding symptoms in von Willebrand disease tend to occur in mucous membranes. deep joint bleeding is rare +5

castlblack New onset bleeding? Immediately rule out vWD! +1

waterloo Vit C def I thought was super tricky. My knee jerk reaction was oh easy bruising, bleeding from gums that's what it has to be. But yeah, I think low platelet is key here. +1

nafilnaf Platelet count would be normal in vWD because there's nothing wrong with the platelets themselves. +1

weirdmed51 @waterloo same thoughts same mistake +

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submitted by ∗dr.xx(176)

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The hallmark of ITP is isolated thrombocytopenia.

https://emedicine.medscape.com/article/202158-workup

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jboud86 Refer to page 419 in FA2019. +2

hello @dr.xx Compared to what? +

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-6 upvote downvote
submitted by ∗makinallkindzofgainz(315)

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Pentad of TTP = FAT RN

Fever
Anemia (MAHA)
Thrombocytopenia
Renal failure
Neurologic symptoms

This is TTP not ITP

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makinallkindzofgainz I seem to have commented on the wrong question, sorry! I wish I was able to delete my comment, but I can't. +7

weirdmed51 Hey how about FART Now +1

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