NBME's love to test on the pentad of TTP, which can be remembered by the mnemonic FAT RN (fever, anemia, thrombocytopenia, renal involvement, neuro symptoms). This pt has fever, confusion (neuro sx), decreased urine production (renal involvement), anemia and thrombocytopenia. Boom. TTP.

• Can't be aplastic anemia if the pt is able to produce other cells evident in the labs.
• Not DIC bc PT and PTT are normal and not increased.
• If pt has fulminant liver failure I would imagine they would not be able to produce their coag factors so again, not probably it.
• Vit B12 Def leads to macrocytic anemia and here they were nice enough to give us MCV which is between 80 and 100.

TTP makes sense with what others said. You can also spot some schistocytes in the blood smear.

FA 2019 page 419. Pt's PC is low and BT is increased. TTP presents with the triad (thrombocytopenia, microangiopathic hemolytic anemia, and acute kidney injury), fever, and neurologic symptoms.