A 45 years old women has one day a history of abdominal pain, fever, confusion, she no take medication, she oriented to place and person but not time, her is 38,1 and Bp 170/98 , the pulse rate is 110, the physical examination is generalised tenderness to palpation , and the blood profile fragmented RBC The result of lab haemoglobin : 9 , platelet: 24.000 total bilirubin: 2.3 creatinine: 3 LDH: 800 leukocyte count: 10.300 Which of the following is most appropriate management:
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: C. plasma exchange
Fever, confusion, renal impairment, thrombocytopenia (24,000), anaemia with fragmented RBCs and high LDH/bilirubin = the TTP pentad. Treatment is urgent plasma exchange (gold standard), started without waiting for ADAMTS13.
- Fever here is part of TTP, so IV antibiotics are not the answer.
- Prednisone is only an adjunct, and transfusion does not treat the cause.
- المصدر
- Hematology🩸.pdf · p. 30
Hematology🩸.pdf · p. 31 - المحاضرة
- MAHA · Hematology · Module C
- ظهر في
- Hema bank