Correct!
5. All of the above
Thrombocytopenia is common in the ICU and is associated with many severe illnesses (3). Most agree that examining the peripheral smear is important in evaluating thrombocytopenia. One algorithm which has been proposed to work up thrombocytopenia is shown in Figure 2.
Figure 2. Algorithm for thrombocytopenia workup. See article for abbreviation definitions.
H. pylori has been associated with thrombocytopenia and our patient presented with diarrhea, although this had largely resolved. In addition, heparin-induced thrombocytopenia (HIT) is fairly common in the ICU and a true medical emergency. Our patient’s H. pylori was negative and his immunoassay for antibodies against heparin/platelet factor 4 (PF4) complexes were also negative.
His peripheral smear showed the presence of 1+ schistocytes.
Which of the following should be done next? (Click on the correct answer to be directed to the fifth of six pages)