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Medical Question of the Day- 21




A 62 year-old man complains of fever and diminished consciousness for 2 days. He has been healthy all his life and he doesn’t take any medications. On examination, he responds inconsistently to commands. His temperature is 103 F, pulse 110/min and blood pressure is 80/56 mmHg. His physical examination is otherwise normal. There is no bleeding. Laboratory test are as follows:

Hemoglobin: 12 g/dl

Leukocyte count: 25,000 – 80% neutrophils

Platelet count: 20,000

D-dimer is high

Fibrinogen level is low

What is the most likely diagnosis?

A – Idiopathic thrombocytopenic purpura

B – Thrombotic thrombocytopenic purpura

C – Disseminated intravascular coagulation

D – Hemophilia a

E – Hemophilia b

Answer




This patient most likely has sepsis leading to disseminated intravascular coagulation. It is confirmed by increased D-dimer and low level of fibrinogen. He has been healthy all his life so, acute infection leading to sepsis is the most likely etiology while major conditions that usually show up in younger age as purpura and hemophilia are not likely associated with this man’s condition.

The correct answer is C

We got 36 Correct answers. Drawing is done and the winner is Abdullah Abobakr

Congratulations and better luck for all of you on next question







78 thoughts on “Medical Question of the Day- 21”

  1. Thank you Ahmer

  2. Thank you Aziz

  3. Thank you Eman

  4. Thank you Daniel

  5. Thank you Abdul ahad

  6. Thank you Afreen

  7. Thank you Mohammad

  8. Thank you Nazir

  9. Thank you Mahesh

  10. Thank you Fahad

  11. Thank you Meera

  12. Thank you AZMIL

  13. Thank you Ibrahim

  14. Thank you Hassan

  15. Thank you Gunel

  16. Thank you Ahmed

  17. Dissiminated intravascular coagulation C

  18. The answer is C
    DIC

  19. C, dic

    We see a drop in fibrinogen,platelets and a high d dimer. Indicates simultaneous coag as well as breakdown. Cause could be sepsis indicated by high leucocytes and neutrophils and fever. The patient has a low bp and also had decreased conciousness which could be due to septicemia and shock. The patient could have had a severe infection leading to dic and shock. To treat we would restore bp and give antipyretics as well as ffp to restore the coagulation factors (loss due tk onverconsumption). If it developed slowly we give heparin

  20. C dic:
    d dimers high and also platelets low and fibrinogen low. fever and leucocytes point to infection so sepsis or sever infection lead to pre Dic which progressed to dic. Theres overconsumption of coag factors. The sepsis could have led to shock which could explain the lowered bp and the neuro symptomps (decreased conciousness)

    Bp would need to be restored maybe anti pyretics for fever and treat the cause (sepsis?) Also could give slow infusion of heparin if it was slow evolving. Give ffp to restore coag factors.

  21. C is the ans

  22. DIC

  23. It is sepsis induced delirium that’s why neurological symptoms and sepsis has led to DIC .. so answer is DIC

  24. C : Disseminated intravascular coagulation

  25. B. since neurological symp are there

  26. It is sepsis complicated by DIC

  27. C- Disseminated intravascular coagulation

  28. Thank you Dr.Rajesh

  29. Thank you Sam

  30. Thank you Moyassar

  31. Thank you Mayur

  32. Thank you Faiza

  33. Thank you Ahmed

  34. Thank you Abdul Aziz

  35. Thank you Janer

  36. Thank you Girish

  37. Thank you Sued

  38. Thank you Ramsy

  39. Idiopathic thrombocytopenic purpura

  40. B.thrombotic thrombocytopenic purpura

  41. DIC

  42. The answer is C, DIC.

  43. A normal Hb value is unlikely for the TTP.

    Increased D-Dimer and decreased fibrinogen->(c)DIC

    Would go for C- DIC.

  44. The answer is B is thrombotic thrombocytopenic purpura.
    Because DIC .haemphiliae will not present with neurological symptoms like this.and presence of decrease conciousness or any neurological symptoms support diagnosis of TTP rather than ITP

  45. Thank you nosheen

  46. Thank you Abdullah

  47. Thank you Ismail

  48. C. DIC

  49. DIC so option C

  50. Thank you Kaushal

  51. B ttp

  52. Thank you Ridwan

  53. Thank you Ali

  54. Thank you Aneela

  55. Thank you Sameer

  56. Thank you Anjum

  57. Thank you Mohammed

  58. Thank you Hoh

  59. C- DIC

  60. C-Disseminated Inravascular Coagulopathy

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