ITP
Quiz by Sadeq K. Ali Al-Salait
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- Q1
Which glycoproteins are commonly targeted by autoantibodies in ITP?
GPVI and GPIV
GPIIb/IIIa and GPIb/IX
GP1b and GPV
GPV and GPIV
GPVI and GPIa/IIa
30s - Q2
Which statement regarding thrombopoietin (TPO) levels in ITP is correct?
TPO levels are significantly elevated
TPO is overproduced but is dysfunctional
TPO levels are relatively low
TPO production is suppressed
TPO levels are irrelevant in ITP
30s - Q3
What is the most characteristic finding on bone marrow biopsy in ITP?
Decreased megakaryocytes
Hypercellular marrow with fibrosis
Increased megakaryocytes with dysplastic changes
Normal or increased megakaryocytes
Normal megakaryocytes count, and morphology exclude ITP
30s - Q4
Which infection is most important to rule out in adults suspected of having ITP?
Cytomegalovirus and EBV
Parvovirus B19
Dengue virus
HIV and Hepatitis C
H. pylori
30s - Q5
Which clinical finding would argue AGAINST a diagnosis of ITP?
History of fever
Epistaxis
Intracranial bleeding
Splenomegaly
Ecchymosis
30s - Q6
A diagnosis of ITP can be established by...?
Bone marrow examination that shows normal or increased megakaryocytes
Exclusion of other causes of isolated thrombocytopenia
Blood film morphology that reveals isolated thrombocytopenia with normal morphology
Detection of dysregulated T cells
Detection of GP-specific Ab
30s - Q7
One of the following blood tests is not consistent with the diagnosis of ITP:
Platelet count below 20x10^9/l
Anisothrombia
Normal bilirubin
Normal creatinine
Elevated LDH
30s - Q8
A patient with ITP is found to have elevated platelet-associated IgG. What is the clinical significance?
Suggests HIV-associated thrombocytopenia
Diagnostic of primary ITP
Indicates suitability for splenectomy
Supports but does not definitively diagnose ITP
Specific for secondary ITP
30s - Q9
What is considered first-line treatment for adult ITP with platelet counts <30×10⁹/L and bleeding symptoms?
TPO receptor agonists
Rituximab
Splenectomy
Corticosteroids
IVIG
30s - Q10
Which therapy carries a risk of intravascular hemolysis when used for ITP?
Rituximab
IV Anti-D
IVIG
Romiplostim
Corticosteroids
30s - Q11
One of the following cases is indicated for H. pylori testing in patient with ITP:
Patient with atypical ITP even without GI symptoms or nonendemic areas
Evidence does not support routine testing for H. pylori in ITP patients
Adult with or without GI symptoms from areas with high prevalence of H. pylori.
Any patient with unexplained thrombocytopenia as part of ITP work up.
Asymptomatic patient with platelet count below 50x10^9/l
30s - Q12
One of the following tests is not part of the basic evaluation for ITP diagnosis according to IWG
HBV
Pregnancy test in women of childbearing potential
HIV
Blood group
Immunoglobulin assay in all children with persistent ITP
30s - Q13
Which finding suggests secondary ITP rather than primary ITP?
Positive DAT
low complement levels
Absence of splenomegaly
Young age at presentation
Platelet count below 10x10^9/l
30s - Q14
Which of the following therapies has direct effects on Fcγ receptor signaling and downstream phagocytosis in ITP?
Anti-D
Fostamatinib
Eltrombopag
IVIG
Romiplostim
30s - Q15
A pregnant woman with ITP is at 36 weeks gestation and platelet count is 42×10⁹/L. She is asymptomatic. What is the next step?
Induce labor
Start rituximab
Start fostamatinib
Continue observation if no bleeding
Give platelet units according to body weight
30s