Hematology: thrombotic thrombocytopenic purpura: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Hematology: thrombotic thrombocytopenic purpura

Sample item

A patient has thrombocytopenia, microangiopathic hemolytic anemia with schistocytes, confusion, and renal impairment. Which diagnosis requires urgent plasma exchange?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Thrombotic thrombocytopenic purpura

Thrombotic thrombocytopenic purpura is a thrombotic microangiopathy with thrombocytopenia and microangiopathic hemolysis; neurologic and renal features may occur. It is a hematologic emergency requiring urgent specialist-directed plasma exchange.

Option by option

  • A. Thrombotic thrombocytopenic purpura (correct)

    Correct. Schistocytes plus thrombocytopenia and systemic features strongly suggest TTP.

  • B. Immune thrombocytopenia

    ITP causes isolated immune-mediated thrombocytopenia without microangiopathic hemolysis.

  • C. Hemophilia A

    Hemophilia A causes a coagulation-factor deficiency with bleeding and prolonged aPTT.

  • D. Iron-deficiency anemia

    Iron deficiency does not cause schistocytes or acute neurologic dysfunction.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Thrombotic thrombocytopenic purpura. Thrombotic thrombocytopenic purpura is a thrombotic microangiopathy with thrombocytopenia and microangiopathic hemolysis; neurologic and renal features may occur.

Why is "Immune thrombocytopenia" not the answer?

ITP causes isolated immune-mediated thrombocytopenia without microangiopathic hemolysis.

Why is "Hemophilia A" not the answer?

Hemophilia A causes a coagulation-factor deficiency with bleeding and prolonged aPTT.

Why is "Iron-deficiency anemia" not the answer?

Iron deficiency does not cause schistocytes or acute neurologic dysfunction.

What concept does this question test?

It tests Hematology: thrombotic thrombocytopenic purpura in General Medicine. It is a hematologic emergency requiring urgent specialist-directed plasma exchange.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Hematology: thrombotic thrombocytopenic purpura?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.