Immune thrombocytopenia Quiz: Ace Your Exams
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A 30-year-old woman comes to the clinic for evaluation of easy bruising. The patient states that for the past few months, she has noticed frequent bruising on many different parts of her body without preceding trauma. This week, she noticed bruising on her right thigh and left arm without recent trauma to the areas. Review of systems is otherwise unremarkable. The patient has no other medical problems and takes no medication. She does not smoke cigarettes, drink alcohol, or use other recreational drugs, over-the-counter medications, or herbal supplements. Vitals are within normal limits. Physical examination shows two small ecchymoses on the right thigh and one small ecchymosis on the left upper arm. There is no evidence of petechiae, lymphadenopathy, or hepatosplenomegaly. Laboratory studies are shown below. Peripheral blood smears are unremarkable. Which of the following tests should be performed next?
| Laboratory Test | Result |
| Hemoglobin | 13.9 g/dL |
| Leukocyte count | 5,000/μL |
| Mean corpuscular volume (MCV) | 89 fL |
| Platelet count | 41,000/μL |
| Reticulocyte count | 1.0% of erythrocytes |
| Lactate dehydrogenase (LDH) | 175 U/L |
| Creatinine | 0.8 mg/dL |
| Prothrombin time (PT) | 12 s |
| Activated partial thromboplastin time (aPTT) | 22 s |
| International normalized ratio (INR) | 1.0 |
| Urinalysis | Normal |
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