Genetic and metabolic disorders: immune thrombocytopenia: practice question

A Pediatrics 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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Pediatrics · Genetic and metabolic disorders: immune thrombocytopenia

Sample item

A well 4-year-old develops petechiae and bruises two weeks after a viral illness. The platelet count is 15,000 per microlitre, haemoglobin and white cell count are normal, and there is no splenomegaly. What would a bone marrow examination show if done?

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

The answer and the reasoning

D. Normal or increased megakaryocytes

In childhood immune thrombocytopenia, antibodies shorten platelet survival while the marrow responds with normal or increased megakaryocytes. Marrow examination is not needed when the rest of the count is normal. Most cases remit within months.

Option by option

  • A. Hypocellular marrow

    A hypocellular marrow is the finding in aplastic anaemia, which affects all lines.

  • B. Decreased megakaryocytes

    Reduced megakaryocytes suggest a production problem such as aplasia.

  • C. Blast cells replacing the marrow

    Blasts would indicate leukaemia, which causes other cytopenias.

  • D. Normal or increased megakaryocytes (correct)

    Correct. Increased peripheral destruction is matched by normal or increased megakaryocytes.

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 Pediatrics question

What is the answer to this Pediatrics question?

The best answer is D, Normal or increased megakaryocytes. In childhood immune thrombocytopenia, antibodies shorten platelet survival while the marrow responds with normal or increased megakaryocytes.

Why is "Hypocellular marrow" not the answer?

A hypocellular marrow is the finding in aplastic anaemia, which affects all lines.

Why is "Decreased megakaryocytes" not the answer?

Reduced megakaryocytes suggest a production problem such as aplasia.

Why is "Blast cells replacing the marrow" not the answer?

Blasts would indicate leukaemia, which causes other cytopenias.

What concept does this question test?

It tests Genetic and metabolic disorders: immune thrombocytopenia in Pediatrics. Marrow examination is not needed when the rest of the count is normal. Most cases remit within months.

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 Genetic and metabolic disorders: immune thrombocytopenia?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.