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NBME 22 Answers

nbme22/Block 1/Question#47

A 25-year-old woman comes to the physician because ...

Immune thrombocytopenic purpura

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submitted by dr.xx(44),

The hallmark of ITP is isolated thrombocytopenia.


jboud86  Refer to page 419 in FA2019. +1  
hello  @dr.xx Compared to what? +  

  • 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 → would cause deep joint bleeding instead of mucosal membrane bleeding. Inherited (Autosomal Dominant), would see symptoms before. PTT can be normal/high.