Knowledge Check

Drag and drop the cards with clinical parameters on the top to the appropriate bucket (TTP pentad or not) on the bottom.

MAHA
Neurological findings
ADAMTS13 < 10%
Skin rash
Fever
Renal dysfunction
Low vWF levels
Thrombocytopenia
Schistocytes on blood smear
Part of pentad
Not part of pentad

MAHA, macroangiopathic hemolytic anemia

The pentad is present in only 5% of patients with thrombotic thrombocytopenic purpura.

True of false: the direct antiglobulin test (DAT, also called Coombs test) is typically positive in patients with thrombotic thrombocytopenic purpura (TTP).

a
True
b
False

True of false: congenital thrombotic thrombocytopenic purpura (TTP) is more common than the acquired form.

a
True
b
False

True of false: red cell transfusion is relatively contraindicated in patients with thrombotic thrombocytopenic purpura (TTP).

a
True
b
False
Platelet transfusions are relatively contraindicated in patients with TTP, not red cell transfusions.

Which of the following should be started in all patients with a first episode of suspected thrombotic thrombocytopenic purpura (TTP):

a
Corticosteroids
b
Plasma transfusion/infusion
Used only if plasma exchange is delayed or in cases of congenital TTP.
c
Plasma exchange
Correct. All patients should receive prompt therapy with plasma exchange.
d
Rituximab
Only in some patients with TTP.
e
Recombinant ADAMTS13
Not available/approved yet.
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