Disseminated intravascular coagulation Quiz: Ace Your Exams
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A 48-year-old woman with a history of HIV on antiretroviral therapy is admitted to the hospital for sepsis secondary to severe community-acquired pneumonia. During the hospital stay, she continues to spike fevers despite antibiotic administration. An infectious disease consult is requested to guide antimicrobial therapy. The medical team is alerted to a critically low platelet count, which was within normal range upon admission. Temperature is 38.2°C (100.8°F), blood pressure is 100/60 mm Hg, heart rate is 111 /minute, respiratory rate is 20 /minute, and oxygen saturation is 98% on 2 L via nasal cannula. The patient is ill appearing. Additional follow-up laboratory tests demonstrate a prolonged PT and aPTT, low fibrinogen, and an elevated d-dimer. Which of the following additional physical examination findings would be consistent with the most likely underlying cause of thrombocytopenia in this patient?
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