A 22-Year-Old Woman Comes to the Emergency Department Due to a Nosebleed

question 815

Multiple Choice

A 22-year-old woman comes to the emergency department due to a nosebleed.  She had a similar episode yesterday, but the bleeding stopped with prolonged local pressure.  On review of systems, the patient has also had easy bruising for the past several months.  She has no significant past medical history and takes no medications.  On physical examination, her heart and lungs appear normal.  The liver span is 8 cm and the spleen is not palpable.  There are scattered ecchymoses over her arms and legs.  Laboratory results are as follows: HIV and hepatitis C tests are negative.  Which of the following is the most likely primary mechanism causing this patient's condition?

• A)Bone marrow aplasia
• B)Bone marrow infiltration by malignant cells
• C)Disseminated intravascular coagulation
• D)Immune destruction of platelets
• E)Platelet sequestration
• F)von Willebrand disease

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Definitions:

Cognition

The cognitive process of gaining knowledge and comprehension via thinking, experiencing, and sensory perception.

Auditory Hallucination

The perception of sound, such as voices, music, or noises, in the absence of any external auditory stimulus.

Hunger Pang

A sudden, sharp feeling of hunger, often experienced as a physical discomfort in the stomach.

Social Cognition

The study of how people process, store, and apply information about others and social situations; it involves understanding how we think about ourselves and others in the social world.