Full Answer Section
Physical Examination: The patient's vital signs are within normal limits. There are multiple bruises on the patient's legs, as well as some red splotches. The patient's gums are slightly bleeding. The rest of the physical examination is unremarkable.
Laboratory Tests: The patient's hemoglobin and hematocrit are normal. The white blood cell count and differential are also normal. The platelet count is 100,000/mm3.
Diagnosis: The patient's low platelet count is consistent with immune thrombocytopenia purpura (ITP). ITP is an autoimmune disorder in which the body's immune system attacks its own platelets. Platelets are blood cells that help to clot blood. When the platelet count is low, the patient is more likely to bleed.
Treatment: The patient will be started on a course of steroids to treat her ITP. The steroids will help to suppress the immune system and allow the platelet count to recover. The patient will also be monitored for any complications of ITP, such as bleeding.
Prognosis: The prognosis for ITP is generally good. Most patients with ITP respond well to treatment and their platelet counts return to normal. However, some patients may have a more chronic form of ITP that requires long-term treatment.
Questions to be addressed:
- Factors that affect fertility (STDs):
There are a number of STDs that can affect fertility. These include chlamydia, gonorrhea, syphilis, and HIV. These infections can cause inflammation and scarring of the reproductive organs, which can make it difficult to conceive.
- Why inflammatory markers rise in STD/PID:
Inflammatory markers are proteins that are released by the body's immune system in response to infection. These markers can include C-reactive protein (CRP), white blood cell count (WBC), and erythrocyte sedimentation rate (ESR). Inflammatory markers rise in STD/PID because the infection causes inflammation in the reproductive organs.
- Why prostatitis and infection happens. Also explain the causes of systemic reaction.
Prostatitis is an inflammation of the prostate gland. The prostate gland is a small gland that sits below the bladder in men. Prostatitis can be caused by a bacterial infection, a virus, or a fungus. Systemic reaction is a reaction that affects the whole body. Systemic reactions can be caused by a number of things, including infections, allergies, and autoimmune disorders.
- Why a patient would need a splenectomy after a diagnosis of ITP:
A splenectomy is the removal of the spleen. The spleen is a small organ that is located in the upper left abdomen. The spleen helps to filter the blood and remove old blood cells. In some cases, patients with ITP may need a splenectomy if their platelet count does not respond to treatment. This is because the spleen can produce antibodies that attack the platelets.
- Anemia and the different kinds of anemia (i.e., micro and macrocytic):
Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells carry oxygen to the body's tissues. There are many different types of anemia, including micro and macrocytic anemia. Microcytic anemia is a type of anemia in which the red blood cells are small and pale. Macrocytic anemia is a type of anemia in which the red blood cells are large and oval.
Discussion of the Case Scenario
The case scenario presented is a classic presentation of ITP. The patient is a young female who has had a recent illness, such as mononucleosis. She presents with bruising and red splotches on her legs, as well as bleeding gums. Her platelet count is low. All of these findings are consistent with ITP.
The patient will be started on a course of steroids to treat her ITP. The steroids will help to suppress the immune system and allow the platelet count to recover. The patient will also be monitored for any complications of ITP, such as bleeding.