MCQology | Quiz of the day

Clinical Case Question

Test your diagnostic skills

Patient Presentation

Case: 65-year-old male with advanced pancreatic cancer presents with fever (38.8°C) and altered mental status.

Hemoglobin (Hb): 8.2 g/dL (previously 11.0) Platelets: 45,000/μL Creatinine (Cr): 2.1 mg/dL (baseline 0.8)

Question

What is the most appropriate next diagnostic step?

A Perform lumbar puncture to rule out meningitis B Transfuse platelets before lumbar puncture C Obtain peripheral blood smear D Observation and repeat labs in 6 hours E Start IV antibiotics for sepsis

Explanation

Correct Answer: C) Obtain peripheral blood smear

Why correct: Blood smear confirms schistocytes for TTP diagnosis.

Why others incorrect:

A) High bleed risk with thrombocytopenia
B) Contraindicated in TTP
D) Delays critical treatment
E) No infection evidence

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