A 34-year-old woman presents to the physician for epistaxis that recurs despite nasal packing at home. She has had many such episodes in the past. Six months ago, she underwent a splenectomy following epistaxis refractory to both intravenous methylprednisolone and immunoglobulin. Platelet count six weeks after surgery was 200,000/μL. Today her platelet count is 40,000/μL. Her peripheral blood smear is shown.
Which of the following is the most likely explanation for this patient’s presentation?
Accessory spleen
Antibodies against glycoprotein Ib
Bernard-Soulier syndrome
Cyclic thrombocytopenia
Thrombasthenia
Thrombotic thrombocytopenic purpura
von Willebrand disease
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Cut-to-the-chase Answer (0:52):
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HY USMLE Answer (10:05):
