need help with your account or subscription? click here to email us (or see the contact page)
join telegramNEW! discord
jump to exam page:
search for anything ⋅ score predictor (โ€œpredict me!โ€)

Retired NBME 22 Answers

nbme22/Block 1/Question#47 (reveal difficulty score)
A 25-year-old woman comes to the physician ...
Immune thrombocytopenic purpura ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags:

 Login (or register) to see more


 +3  upvote downvote
submitted by โˆ—drmohandes(193)
get full access to all contentpick a username
  • 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 โ†’ would cause deep joint bleeding instead of mucosal membrane bleeding. Inherited (Autosomal Dominant), would see symptoms before. PTT can be normal/high.
get full access to all contentpick a username
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 +



 +1  upvote downvote
submitted by โˆ—dr.xx(176)
get full access to all contentpick a username

The hallmark of ITP is isolated thrombocytopenia.

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

get full access to all contentpick a username
jboud86  Refer to page 419 in FA2019. +2
hello  @dr.xx Compared to what? +



 -6  upvote downvote
submitted by โˆ—makinallkindzofgainz(315)
get full access to all contentpick a username

Pentad of TTP = FAT RN

  • Fever
  • Anemia (MAHA)
  • Thrombocytopenia
  • Renal failure
  • Neurologic symptoms

This is TTP not ITP

get full access to all contentpick a username
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



Must-See Comments from nbme22

sacredazn on Unrearranged immunoglobulin gene
seagull on Decreased binding of RNA polymerase
seagull on Anticholinergic
mcl on Area labeled โ€˜Dโ€™
liverdietrying on Release of stored thyroid hormone from a ...
kernicterusthefrog on Displacement
keycompany on Negative nitrogen balance
joha961 on Displacement
imgdoc on Area labeled โ€˜Cโ€™ (Abducens nucleus, right)
alwaysanonymous on 25 mL/cm H2O
drdoom on 1 in 600
seagull on Glutamine
yotsubato on Phase variation
bubbles on Acute retroviral infection

search for anything NEW!