UKMLA PLAB AMC USMLE Prometric MCQ

Question Number 0728

Question:
A 34 year old previously healthy female hotel receptionist has acute onset of confusion and hematuria. She is noted to have a severe petechial ecchymosis. She is noted to be febrile. Initial investigations reveal anemia and a severe thrombocytopenia (<20,000/mL), prolonged bleeding time, elevated creatinine and elevated BUN. A blood film demonstrates extensive erythroid fragmentation (schistocytes), nucleated RBCs, and significant polychromatophilia. There are less than 2 platelets per high power field. She is likely to require

a) plasmapheresis and plasma infusion
b) half strength Normal Saline
c) lactated Ringer's injection
d) Packed cells
e) Whole blood