A patient has a platelet count of 650 109/L. The other ...

[ap345]

A patient has a platelet count of 650  109/L. The other hematology tests are normal. No evidence of hemostasis failure exists. Which of the following is most likely?
 
  a. Reactive thrombocytosis
  b. Essential thrombocythemia
  c. DIC
  d. Polycythemia vera

Question 2

A 23-year-old man is brought by helicopter to a major trauma center after a severe motorcycle accident. He has major abdominal trauma, including a ruptured spleen, and is taken to surgery, where his spleen is removed.
 
  Two weeks after surgery, his platelet count peaks at 950 x 109/L. What is the most likely cause for this high platelet count?
 
  a. Reactive thrombocytosis secondary to trauma
  b. Essential thrombocythemia
  c. Postsplenectomy thrombocytosis
  d. Reactive thrombocytosis secondary to acute blood loss

[ally]

Answer to Question 1

ANS: A
The term reactive thrombocytosis is defined as an abnormally high platelet count, typically more that 450 x 109/L, secondary to inflammation, trauma, or some other underlying and seemingly unrelated conditions. The platelet count does not usually exceed 800 x 109/L, and the elevation is transient.

Answer to Question 2

ANS: C
Removal of the spleen characteristically results in a thrombocytosis that can reach or even exceed 1000 x 109/L (1 million/mL). The platelet count usually peaks 2 to 3 weeks after surgery and generally remains elevated for 1 to 3 months. Platelet counts generally are not this elevated in reactive thrombocytosis, and they do not peak 2 to 3 weeks after surgery.