3-year-old with ITP, CBC review. Report immediately to provider?

Correct Answer: B

Rationale: The correct answer is B: Hemoglobin 7.1 g/dL. In ITP, low platelet count is common but does not typically require immediate reporting unless there are signs of significant bleeding. Hemoglobin of 7.1 g/dL indicates severe anemia, which requires prompt evaluation to assess the need for transfusion and determine the underlying cause. Increased eosinophils (A) are not typically concerning in ITP. Platelet count of 40,000/mm³ (C) is expected in ITP. Elevated reticulocyte count (D) may indicate compensatory response to anemia but does not warrant immediate reporting.

Correct Answer: A

Rationale: The correct answer is A: Thrombosis. Thrombotic thrombocytopenic purpura (TTP) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and neurological deficits. Thrombosis is not a typical feature of TTP. In TTP, platelet aggregation leads to microthrombi formation, causing microangiopathic hemolytic anemia, thrombocytopenia, and neurological symptoms. Thrombosis, on the other hand, is more commonly associated with conditions such as deep vein thrombosis or pulmonary embolism. Therefore, choice A is not associated with TTP, making it the correct answer. Choices B, C, and D are incorrect as they are all features commonly seen in TTP.

Correct Answer: A

Rationale: Neutrophilia is the correct answer for chronic bacterial infection. Neutrophils are the first responders to bacterial infections, leading to an increase in their count. Basophils are involved in allergic reactions, not bacterial infections. Lymphocytosis is seen in viral infections. Eosinophilia is associated with parasitic infections and allergic responses.

Correct Answer: D

Rationale: Koilonychias, characterized by spoon-shaped nails, is specific to iron deficiency anemia due to impaired nail growth. In hemolytic anemia, sickle cell disease, and thalassemia major, nail abnormalities are not typically observed. Iron deficiency leads to brittle, spoon-shaped nails. Consequently, option D is the correct answer.

Correct Answer: B

Rationale: The correct answer is B: Leukemoid reaction. Döhle bodies are blue-gray cytoplasmic inclusions seen in neutrophils, indicating rough endoplasmic reticulum disruption. Leukemoid reaction is a benign condition with elevated white blood cell count due to infections, inflammation, or stress. In chronic myeloid leukemia (A), abnormal myeloid cells are present but not Döhle bodies. Chediak-Higashi syndrome (C) is a rare genetic disorder with giant granules in neutrophils, not Döhle bodies. Infectious mononucleosis (D) shows atypical lymphocytes but not Döhle bodies.