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Question 3

A 27 year old man is referred to clinic with easy bruising and epistaxis.  Examination reveals numerous large ecchymoses as well as a palpable mass in the left upper quadrant consistent with splenomegaly.

Blood results
Hb 13 g/dL WC 3.2 Plt 78
Blood film: leukoerythroblastic with tear drop poikilocytes and large platelets

PT 11.4  APTT 28.3

PFA 100 >300s

Platelet aggregometry
ADP - reduced aggregation
Collagen - reduced aggregation
Ristocetin - normal 
Arachdonic acid - normal

Platelet nucleotides - normal   

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