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confidenceinterval
RIP anyone with a learning disability. I honestly think someone tried really hard to write something this confusing.
+4
faus305
Quentin Tarantino wrote this one
+4
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spow
But why are there no bite cells? Question stem states that there is normal morphology? That's why I didn't pick accessory spleen
+2
makinallkindzofgainz
Bite cells are seen when splenic macrophages take "bites" out of hemoglobin precipitates in G6PD deficiency, which doesn't have to do with our question.
This patient had a splenectomy 3 months ago, 6 weeks later showed Howell-Jolly bodies (asplenia), and then today now has normal erythrocytes (spleen is working again somehow = accessory spleen)
+5
snripper
@spow Bite cells are associated with G6PD deficiency, not ITP.
+1
srdgreen123
Main takeaway is the HJ bodies. They're seen pretty much whenever you have no spleen. So if they dissapear, that means another spleen-like structure has showed up
+3
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sympathetikey
Makes total sense looking back. Just didn't know that was a thing :)
+38
sugaplum
Fun fact: Meredith from Grey's anatomy got her idea for Mini livers from a patient who presented with an accessory spleen.... and who said watching TV doesn't count as studying
+28
123ojm
have gotten at least 10+ NBME or Uworld questions correct because of grey's anatomy
+3
rongloz
LOL got this right because of Grey's anatomy too
+
lulumomovicky
I literally picked accessory spleens because in remembered Meredith did her mini liver lol
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submitted by โalexxxx30(68)
did anyone else have to reread this question several times? The jumping back and forth from "this happened before, 1 week after, 6 weeks after" then this happened today, then" this happened 6 weeks postop" gave me whiplash. Tell the story in order! haha