A 72-Year-Old Woman Is Evaluated for Low Platelet Count

question 667

Multiple Choice

A 72-year-old woman is evaluated for low platelet count.  She is currently being treated for an uncomplicated urinary tract infection with ciprofloxacin.  A complete blood count sent as part of the workup showed a platelet count of 12,000/µL.  The patient's medical problems include type 2 diabetes mellitus, hypertension, hypercholesterolemia, osteoarthritis, and mild dementia.
Her temperature is 37.2° C (99° F) , blood pressure is 130/80 mm Hg, pulse is 84/min, and respirations are 14/min.  Physical examination shows no bruises, petechiae, or mucosal bleeding.  Cardiopulmonary examination is normal.  The abdomen is soft and nontender with no hepatosplenomegaly.  The remainder of the examination is within normal limits.
Repeat laboratory results are as follows:

Repeat complete blood count sent in a heparin tube shows a platelet count of 135,000/µL.
Which of the following is the most likely diagnosis?

• A)Antiphospholipid antibody syndrome
• B)Heparin-induced thrombocytopenia
• C)Idiopathic thrombocytopenic purpura
• D)Parvovirus B19 infection
• E)Platelet clumping

---

Definitions:

Civil War

A conflict within a country between opposing factions or regions, historically significant examples include the American Civil War fought from 1861 to 1865.

Cooperative Basis

A foundational principle of working together where individuals or groups collaborate, usually in economic ventures, for mutual benefit.

Shaker Communities

Religious communities known for their simple living, architecture, and furniture, as well as for practicing celibacy and communal living.

Celibacy

The state of abstaining from marriage and sexual relations, often for religious or spiritual reasons.