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Posted by IMG from IP 99.155.139.139 on January 25, 2014 at 12:39:12:

a 40 year old..women present to her physician office with the rash on her legs for past 4 days...she recalls recent respiratory infections..on examination there is a small amount of blood
in her nostrils...there are several hemmorragic bullae in her oral cavity ...there are several hemmorragic bullae in her oral cavity ..her lungs are clear cardiac examination is unremarkable
,her abdomen is soft with no palpable spleen or liver..laboratory show.
leukocytes=9000/mm3
hemoglobin =10.1 g/dl.
platelets=9000mm3.
peripheral smear=reticulotosis with normal erythrocytes and megathrombocytes.
An ultrasound is negative for masses or fluid collections.which of the following is the most appropriate next step in management..?

a...cryoprecipitate.
b.immunogloulins.
c.prednisolone
d.plasmaphersis.
e.spleenectomy..


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