MCQ Hematology Answer 29

The Correct Answer is D

Explanation:

The RBC Howell-Jolly bodies should be the tip-off that the patient has had a prior splenectomy. Further questioning would reveal that the patient failed to mention a splenectomy at the age of 14 after splenic injury in a motor vehicle accident. You missed the surgical scar on physical exam. Postsplenectomy patients can sometimes have lifelong mild elevations of either their WBC count or their platelet count.

The gynecologist was correct to obtain several platelet counts over time to make sure the platelet elevation was persistently increased. Reasons for reactive thrombocytosis include iron deficiency, splenectomy, postsurgical state, infection or inflammation, and occult malignancy.

There is currently no diagnostic test for essential thrombocytosis. It remains a diagnosis of exclusion and can be entertained only after all forms of reactive thrombocytosis have been ruled out.

Category: Hematology MCQs