Reactive Thrombocytosis in RA — SCE Rheumatology MCQ

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HardRheumatoid ArthritisReactive Thrombocytosis in RASCE Rheumatology

A 60-year-old woman with RA has blood monitoring showing a platelet count of 550 x10^9/L (elevated). She has active inflammatory disease with DAS28 5.2. What is the most likely cause of her thrombocytosis?

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Correct answer: C — Reactive thrombocytosis secondary to chronic inflammation

The best answer is “Reactive thrombocytosis secondary to chronic inflammation”. The full clinical pattern is most consistent with Reactive thrombocytosis secondary to chronic inflammation; competing diagnoses share isolated features but not the decisive combination described. The remaining choices—“Essential thrombocythaemia, after safety review”, “Iron deficiency, after specialist assessment”, “Drug side effect, with clinical reassessment”, “Splenic sequestration, within a rheumatology pathway”—are credible in related rheumatology presentations, but each addresses a different diagnosis, investigation, treatment sequence or complication and does not fit the decisive findings in this stem.

Reference: NICE NG100 rheumatoid arthritis in adults: https://www.nice.org.uk/guidance/ng100/chapter/Recommendations