A 61 year old woman with longstanding chronic kidney disease presents with fatigue and recurrent epistaxis. She has no family history of bleeding disorders. Laboratory studies show hemoglobin 8.9 g/dL, BUN 92 mg/dL, creatinine 6.4 mg/dL, normal platelet count, normal PT, and normal PTT. Which of the following best explains her bleeding tendency?
- A)Impaired platelet adhesion and aggregation due to uremic toxinsGABARITO
- B)Autoimmune destruction of platelets in the spleen
- C)Vitamin K deficiency leading to low clotting factors
- D)Factor VIII deficiency from defective hepatic synthesis
- E)Disseminated intravascular coagulation with consumption of clotting proteins
Explicação
Advanced uremia causes a qualitative platelet defect that leads to mucosal bleeding despite a normal platelet count and normal coagulation studies. The retained uremic toxins impair platelet adhesion and aggregation, and dialysis or desmopressin can improve bl... Ver explicação completa e trilha adaptativa →