Haematology and oncology: recognition: 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 · Haematology and oncology: recognition

Sample item

A 30-year-old woman has fever, confusion, renal dysfunction, thrombocytopenia and a microangiopathic haemolytic anaemia with schistocytes. PT and aPTT are normal and ADAMTS13 activity is below 10 percent. What is the diagnosis?

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

The answer and the reasoning

B. Thrombotic thrombocytopenic purpura

Severely deficient ADAMTS13 allows ultra-large von Willebrand multimers to form platelet microthrombi. Urgent plasma exchange is indicated. Normal coagulation tests and a low enzyme activity separate it from DIC and HUS.

Option by option

  • A. Immune thrombocytopenia

    Immune thrombocytopenia has no haemolysis or schistocytes.

  • B. Thrombotic thrombocytopenic purpura (correct)

    Correct. The pentad with ADAMTS13 deficiency is diagnostic.

  • C. Haemolytic uraemic syndrome

    HUS is dominated by renal failure after diarrhoea and has normal ADAMTS13.

  • D. Disseminated intravascular coagulation

    DIC prolongs clotting tests and consumes fibrinogen.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Thrombotic thrombocytopenic purpura. Severely deficient ADAMTS13 allows ultra-large von Willebrand multimers to form platelet microthrombi.

Why is "Immune thrombocytopenia" not the answer?

Immune thrombocytopenia has no haemolysis or schistocytes.

Why is "Haemolytic uraemic syndrome" not the answer?

HUS is dominated by renal failure after diarrhoea and has normal ADAMTS13.

Why is "Disseminated intravascular coagulation" not the answer?

DIC prolongs clotting tests and consumes fibrinogen.

What concept does this question test?

It tests Haematology and oncology: recognition in General Medicine. Urgent plasma exchange is indicated. Normal coagulation tests and a low enzyme activity separate it from DIC and HUS.

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 Haematology and oncology: recognition?

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.