Step I nbme question

[arda]

Advertisement - Members don't see this ad

A previously health 32 year old woman has the onset of recurrent headaches, she develops nausea, vomiting, weakness, abdominal pain, and easy bruisability. Her temperature is 38.5 c (101.3 f). Labouratory studies show:
Hemoglobin 6.9 g/dl
Leucocyte count 15,000/mm3
Mean corpuscular volume 78 um3
Platelet count 30,000/ mm3

She is immediately admitted to the hospital. Over the next few days, she develops progressive lethargy and lapses into a coma. A peripheral blood smear is most likely to show:
a)Macrocytes
b)Shistocytes
c)Sickle cells
d)Spherocytes
e)Target cells

Most people answered B,but i picked c thinking that she is in sickle cell crysis

 

[Apoplexy__]

Easy bruisability + low platelets wouldn't be caused by a sickle cell crisis, but would be caused by TTP/HUS.

Intravascular microthrombi --> Shearing of RBC's --> schistocytes + low platelets.

 

[Psai]

Headache, abdominal pain, low hemoglobin, low mcv and low platelets/bruising -> TTP/HUS as kirbymiester said
Look it up on first aid, there's a pentad of symptoms

For sickle cell, they would probably include that she's African American and you would probably have vasoocclusive crises rather than neurological symptoms.