Question

A 41-year-old previously healthy woman presents to the ED with gingival bleeding and epistaxis over the past 4 days. She takes no medications and has no recent travel. On exam, you note scattered petechiae, but otherwise it is normal. Her hemoglobin is 12.5 g/dL, INR 1.1, PTT 25, and platelets 14,000/µL. A peripheral blood smear shows few large, well-granulated platelets. Which of the following is the most appropriate initial treatment?

a. Corticosteroids and immunoglobulin
b. Observation
c. Platelet transfusion
d. Splenectomy

Answer 1

The most appropriate initial treatment for the patient is platelet transfusion.

Step-by-step explanation:

The most appropriate initial treatment for the patient described is c. Platelet transfusion. The patient's symptoms and laboratory findings are consistent with thrombocytopenia, which is characterized by low platelet count. Platelet transfusion is the immediate intervention to increase the platelet count and prevent further bleeding.