PAINE #PANCE Pearl – Hematology



31-year-old female, with a history of controlled SLE, presents to your office with a 2 week history of headache, weakness, dizziness, and nausea.  She also reports a new rash on her legs that is non-pruritic.  She denies any recent illnesses, sick contacts, vomiting, abdominal pain, cough, or shortness of breath.  She has been taking hydroxychlorquine for her SLE and has had little complications from this disease.


Vital Signs

 

BP-131/72, HR-116, RR-15, O2-100%, T-101.2 F


Physical Exam

 

GeneralMild distress

Skin

Image result for ttp rash

HEENT

index

NeckSupple, no LAD

PulmonaryCTA without adventitial breath sounds

CVTachycardic without M/G/R

AbdomenS/NT/ND

PV2+ throughout

Neurologic5/5 strength throughout, 2+ reflexes throughout

PsychiatricA&Ox3


Laboratory Screening

 

fishbones


  1. What is the most likely diagnosis?

  2. What other laboratory tests can be helpful in making the diagnosis?

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s