skip to main content

Immune thrombotic thrombocytopenic purpura — ABIM Board MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHematology/OncologyImmune thrombotic thrombocytopenic purpuraABIM Board

A 38-year-old woman has confusion, petechiae, and acute kidney injury. Hemoglobin is 7.8 g/dL, platelets are 14,000/mm3, creatinine is 1.7 mg/dL, LDH is elevated, haptoglobin is undetectable, and smear shows schistocytes. PT and aPTT are normal. ADAMTS13 testing is sent. Which of the following is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Immediate plasma exchange plus glucocorticoids

Thrombotic thrombocytopenic purpura is a medical emergency with microangiopathic hemolytic anemia, thrombocytopenia, neurologic findings, and relatively normal coagulation tests. Plasma exchange and immunosuppression should start immediately without waiting for ADAMTS13 results.

Reference: ASH Thrombotic Microangiopathy/TTP Guidance