Approach to bleeding disorders (thrombocytopenia) Quiz: Ace Your Exams
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A 68-year-old man with a past medical history of coronary artery disease, hyperlipidemia, and hypertension is found to have acute right leg pain and swelling during morning rounds. Five days ago, he was admitted to the hospital with community-acquired pneumonia and was intubated due to acute hypoxic respiratory failure. His medications during the admission included aspirin, atorvastatin, losartan, ceftriaxone, azithromycin, and subcutaneous heparin. He was extubated yesterday and transferred to the step-down unit. Vitals are within normal limits. Pulses are intact in bilateral lower extremities. On examination, there is swelling of the right calf with tenderness to palpation in the posterior calf. A Doppler ultrasound shows a deep vein thrombosis in the right popliteal vein. Laboratory studies from the morning are shown below. Which of the following studies should be performed next to confirm the most likely diagnosis?
| Today | On admission (5 days ago) | |
| Hemoglobin | 10.6 g/dL | 11.1 g/dL |
| Leukocyte count | 8,500 /mm3 | 16,100 /mm3 |
| Platelet count | 78,000/mm3 | 278,000/mm3 |
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