Answer to Question 1
ANS: B
The platelet count on this patient is normal; however, the bleeding time is abnormal, which suggests platelet dysfunction. Of the disorders listed, only dense granule deficiency has the platelet aggregation results that are listed. Patients with Bernard-Soulier disease have normal aggregation studies with every agonist except ristocetin, which is abnormal. The reverse is true for Glanzmann thrombasthenia: they have normal aggregation with ristocetin but have no primary wave, as well as no secondary wave with other agonists. Patients with gray platelet syndrome have a moderate thrombocytopenia, prolonged bleeding time, and large platelets that appear gray on a Wright-stained blood film because of the absence of a-granules. Platelet aggregation studies are unremarkable.
Answer to Question 2
ANS: C
Allergic purpura does not interfere with platelet function. All of the other listed conditions or situations can affect platelet function.
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