A 28 year old woman is referred by her obstetrician for management of increasing thrombocytopenia in the 36th week of her pregnancy. She was evaluated for a decreased platelet count of 31,000/l 6 weeks ago, and she failed a course of prednisone (1 mg/kg) given for presumptive ITP after her bone marrow showed adequate to increased megakaryocytes. Careful questioning reveals that she has a lifelong history of mild bruising and that she has had heavy menstrual periods; her father is also said to have easy bruising, epistaxis requiring medical attention to control it, and bleeding after dental extractions. Initial screening studies show a platelet count of 24,000/l, and a normal prothrombin time, aPTT, thrombin time, and fibrinogen. Further tests show the von Willebrand factor (VWF) activity (Ristocetin cofactor) level is 95%, the VWF antigen level is 102%, and the factor VIII level is 110%. What other tests should be done to arrive at a diagnosis?
-
Platelet aggregation studies
-
Studies to evaluate platelet size distribution
-
Thromboelastogram test
-
VWF multimer study
-
Bleeding time
Answer
Category:
Hematology MCQs
POST COMMENT
0 comments:
Post a Comment