Myeloproliferative disorders Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 51-year-old female comes to the emergency department because of shortness of breath that began an hour ago. Three days ago, the patient returned from a business trip in Europe. Past medical history is notable for hypertension. The patient has been taking oral estrogen for management of menopausal symptoms. Her temperature is 37.8°C (100.0°F), blood pressure is 148/89, pulse is 130/min, and respiratory rate is 27/min. Oxygen saturation is 86% on room air. Physical examination reveals splenomegaly. Coagulation studies show a prothrombin time (PT) of 12 seconds (reference range: 11-15 seconds) and partial thromboplastin time (PTT) of 34 seconds (reference range: 25-40 seconds). A peripheral blood smear shows excess platelets, as demonstrated by the following:  

A microscopy image shows numerous red blood cells with biconcave disc shapes scattered on a white background, interspersed with smaller, irregular platelets.
Reproduced from: Wikimedia Commons   

Computed tomography subsequently confirms the presence of a pulmonary embolus. Which of the following best explains the pathophysiology of this patient presentation?  

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