AssessmentsThrombotic thrombocytopenic purpura (NORD)
Thrombotic thrombocytopenic purpura (NORD)
Glucocorticoids are indicated for (hereditary/acquired) thrombotic thrombocytopenic purpura.
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 16-year-old Caucasian girl is brought to the emergency department by her mother because of a 5-day history of fever, fatigue, and "strange behavior". Her medical history is noncontributory. Upon further interrogation, the girl reports that she "hears voices" telling her that "she has been chosen to be the new savior of god". On physical exam, the patient is disoriented. Further inspection shows skin jaundice, conjunctival pallor, and petechial rashes over her face and shoulders. Her temperature is 38.6°C (101.48°F), pulse is 131/min, respirations are 18/min, blood pressure is 130/70 mmHg. Laboratory studies show a decreased platelet count, increased creatinine and blood urea nitrogen, and increased indirect bilirubin. A peripheral blood smear is obtained and shown below.
Which of the following is the most likely cause of this patient's condition?