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| * neuroq1 |
| | #531297 |
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A 29-year-old white female is hospitalized following a right middle cerebral artery stroke confirmed on an MRI scan. Her past medical history is remarkable only for a history of an uncomplicated tonsillectomy during childhood, and a second-trimester miscarriage 3 years ago. The only remarkable finding on physical examination is left hemiplegia.
The initial laboratory workup reveals normal hematocrit and hemoglobin levels, a normal prothrombin time, and a platelet count of 200,000/mm3 (N 140,000-440,000). The active partial thromboplastin time is 95 sec (N 23.6-34.6), and it does not normalize when the patient's serum is mixed with normal plasma. A serum VDRL is positive, and a serum FTA-ABS is nonreactive.
Which one of the following is the most likely diagnosis?
a)Hemophilia
b)Neurosyphilis
c)Antiphospholipid syndrome
d)Thrombotic thrombocytopenic purpura
e)Protein C deficiency |
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| * Re:neuroq1 |
| #2189874 |
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CCC,,,,the VDRL is a false positive and the negative FTA-Abs shows it. A common cause of this one and the second trimester abortion is Antiphospholipid syndrome.
Antiphospholipid syndrome (APS or APLS) or antiphospholipid antibody syndrome is a disorder of coagulation that causes blood clots (thrombosis) in both arteries and veins as well as pregnancy-related complications such as miscarriage, stillbirth, preterm delivery, or severe preeclampsia. The syndrome occurs due to the autoimmune production of antibodies against phospholipid (aPL), a cell membrane substance. In particular, the disease is characterised by antibodies against cardiolipin (anti-cardiolipin antibodies) and β2 glycoprotein I. |
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