Pathology EMQ.

Name: Marie-Caroline Nogaro

Theme: Obstetric Haematology

OPTION LIST

A	Caesarian section delivery	I	No treatment necessary
B	Magnesium Sulphate infusion	J	Blood transfusion
C	Monitor maternal platelet count	K	Factor VIII infusion
D	Plasmapheresis	L	Induction of labour
E	Platelet transfusion	M
F	Prednisolone	N
G	Splenectomy	O
H	IV immunoglobulin	P

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. A 25-year-old woman presents to her GP with ecchymoses on her buttock and several episodes of epistaxis. She is in her 1^st trimester of pregnancy. FBC reveals a platelet count of 20 x 10⁹/L.

2. On routine check up, a 32-year-old woman who is in late gestation is noted to have a platelet count of 80 x 10⁹/L. She has no history of thrombocytopenia except during her previous pregnancy.

3. A 30-year-old woman, with a history of a few recent episodes of right upper quadrant pain, is to have a caesarian delivery. Her platelet count is monitored and is 40 x 10⁹/L.

4. A 28-year-old woman in early pregnancy presents to her GP with jaundice, nausea and vomiting, headache and altered consciousness. FBC reveals a platelet count of 80 x 10⁹/L and haematocrit of < 30%. There are schistocytes on her peripheral blood smear.

5. A 25-year-old woman is in the third trimester of her first pregnancy. She presents to her GP with swelling of her hands and face. Further examination reveals proteinuria and a mild thrombocytopenia.

ANSWERS

1. F

2. C

3. E

4. D

5. B