Refractory ITP TPO-RA — RACP Adult Medicine MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: B — A thrombopoietin-receptor agonist with ongoing platelet and thrombosis monitoring
The best answer is “A thrombopoietin-receptor agonist with ongoing platelet and thrombosis monitoring”. TPO-receptor agonists such as eltrombopag or romiplostim are effective second-line options and align with a preference to avoid splenectomy and broad immunosuppression. They require monitoring and usually maintain rather than permanently cure ITP. Rituximab and splenectomy remain alternatives according to duration, comorbidity and preference; chronic high-dose steroid and routine transfusion are harmful.
Reference: Medical Journal of Australia: Adult immune thrombocytopenia consensus guideline: https://www.mja.com.au/journal/2022/216/1/consensus-guidelines-management-adult-immune-thrombocytopenia-australia-and-new