Mrs. Neal is a 32-year-old female who had been sick with a cold virus for 10 days. She states that she had flu symptoms of cough, sore throat, and fatigue. It has been 3 weeks since the cold, and she continues to be fatigued and finds it hard to get enough energy to do things. Mrs. Neal says she has noted that she has been bruising easily. She hit her arm accidentally on the edge of a counter, and now she has a large bruise. She has also noted little purple spots all over her hands and chest. On exam it is noted that she does have a large bruise on her right arm and petechiae and purpura over her chest and hands. Lab work comes back with a platelet count of 40,000mm3.
1. Mrs. Neal has been diagnosed with idiopathic thrombocytopenic purpura (ITP). Explain what it is and who can get it.
2. Discuss the four mechanisms of thrombocytopenia.
3. What symptoms would you expect to see in a patient with ITP, and which tests would be used to confirm the diagnosis?