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Retired NBME Free 120 Answers

free120/Block 1/Question#7 (reveal difficulty score)
An asymptomatic 44-year-old man is found to ...
Petechiae ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—madden875(25)
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From Goljan:

Platelet problem = epistaxis, echymoses, petechia, bleeding from superficial scratches

Coagulation problem = late re-bleed, Menorrhagia, GI bleeds, hemarthroses

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step7777  Also that: Platelet problem = primary hemostasis = superficial bleeding Coagulation problem = secondary hemostasis = "deep" / internal bleeding +2
zevvyt  i thought I read that INR was 12 and got real confused on that question +
topgunber  is there a reason for the decreased PTT? or is that just a distraction +
justanotherimg  @topgunber It throwed me off as well, but I found this on google- Sometimes a traumatic or difficult blood collection may result in activation of the coagulation pathway in the sample, resulting in a shortened aPTT time. So I guess it was just a distraction. +
icrieeverytiem  It's still confusing. The decreased PT and PTT seemed like hypercoagulability and the only rationale to eliminate that is that he is asymptomatic. Unfortunately I picked DVT and lost an easy point. +1
athenathefirst  also is subungal hemorrhage seen in infective endocarditis? +



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submitted by โˆ—handsome(3)
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HIV is a viral agent that can cause aplastic anemia.

which can have Symptoms: fatigue, malaise, pallor, purpura, mucosal bleeding, petechiae, infection

FA20 pg 421

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