Haematology: immune thrombocytopenia: practice question

A Pathology 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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Pathology · Haematology: immune thrombocytopenia

Sample item

A 6-year-old child develops petechiae and gum bleeding two weeks after a viral illness. Platelet count is 12,000 per microlitre with normal haemoglobin and leukocyte count, and no splenomegaly. The marrow shows increased megakaryocytes. What is the underlying mechanism?

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

The answer and the reasoning

C. IgG autoantibodies to platelet glycoproteins GPIIb/IIIa with splenic clearance

Immune thrombocytopenia is caused by autoantibodies, mainly against GPIIb/IIIa and GPIb, which opsonise platelets for removal by splenic macrophages. Megakaryocytes increase in the marrow in compensation. Childhood disease often follows viral infection and usually resolves spontaneously, while treatment, when needed, is with corticosteroids or intravenous immunoglobulin.

Option by option

  • A. Sequestration of platelets in a massively enlarged spleen

    Hypersplenic sequestration needs splenomegaly, which is absent in this child.

  • B. Failure of marrow megakaryocyte production

    Marrow failure would give reduced megakaryocytes and usually other cytopenias.

  • C. IgG autoantibodies to platelet glycoproteins GPIIb/IIIa with splenic clearance (correct)

    Correct. Antibody-coated platelets are destroyed in the spleen, while the marrow responds with more megakaryocytes.

  • D. Widespread microthrombi consuming platelets

    Platelet consumption in microthrombi occurs in DIC and thrombotic microangiopathies, with abnormal coagulation or red cell fragments.

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.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, IgG autoantibodies to platelet glycoproteins GPIIb/IIIa with splenic clearance. Immune thrombocytopenia is caused by autoantibodies, mainly against GPIIb/IIIa and GPIb, which opsonise platelets for removal by splenic macrophages.

Why is "Sequestration of platelets in a massively enlarged spleen" not the answer?

Hypersplenic sequestration needs splenomegaly, which is absent in this child.

Why is "Failure of marrow megakaryocyte production" not the answer?

Marrow failure would give reduced megakaryocytes and usually other cytopenias.

Why is "Widespread microthrombi consuming platelets" not the answer?

Platelet consumption in microthrombi occurs in DIC and thrombotic microangiopathies, with abnormal coagulation or red cell fragments.

What concept does this question test?

It tests Haematology: immune thrombocytopenia in Pathology. Megakaryocytes increase in the marrow in compensation. Childhood disease often follows viral infection and usually resolves spontaneously, while treatment, when needed, is with corticosteroids or intravenous immunoglobulin.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Haematology: immune thrombocytopenia?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology 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.