#february2020mccqe1
A 40-year-old woman presents to her physician’s office with a rash on her legs for the past 4 days. She recalls a recent respiratory infection. On examination, there is a small amount of blood in her nostrils. There are several hemorrhagic bullae in her oral cavity. Her lungs are clear, cardiac examination is unremarkable, and her abdomen is soft with no palpable spleen or liver. Both lower extremities have multiple dark blue ecchymoses. Laboratory analysis reveals:
Leukocyte count: 9000/mm3
Hemoglobin: 10.1 g/dL
Platelets: 9000/mm3
Peripheral smear: Reticulocytosis with normal erythrocytes and megathrombocytes
An ultrasound examination is negative for masses or fluid collections. Which of the following is the most appropriate next step in management?
(A) Cryoprecipitate
(B) Immunoglobulins
(C) Prednisone
(D) Plasmapheresis
(E) Splenectomy
A 40-year-old woman presents to her physician’s office with a rash on her legs for the past 4 days. She recalls a recent respiratory infection. On examination, there is a small amount of blood in her nostrils. There are several hemorrhagic bullae in her oral cavity. Her lungs are clear, cardiac examination is unremarkable, and her abdomen is soft with no palpable spleen or liver. Both lower extremities have multiple dark blue ecchymoses. Laboratory analysis reveals:
Leukocyte count: 9000/mm3
Hemoglobin: 10.1 g/dL
Platelets: 9000/mm3
Peripheral smear: Reticulocytosis with normal erythrocytes and megathrombocytes
An ultrasound examination is negative for masses or fluid collections. Which of the following is the most appropriate next step in management?
(A) Cryoprecipitate
(B) Immunoglobulins
(C) Prednisone
(D) Plasmapheresis
(E) Splenectomy
