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free120/Block 1/Question#32 (reveal difficulty score)
A 20-year-old woman comes to the physician ...
von Willebrand disease ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ

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submitted by โˆ—imnotarobotbut(178),
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ihTs is a abd eu.qtsoni tPatelel ggrotneagai item eibgn ,mlaorn ok enif I acn ese tah.t utB WFV azitbseils trafoc 8 nda dyu'o ees an ineerasc in PTT isf(rt elin enxt ot VWF ni Frtsi .)iAd yhW si ihetr PTT nrlom?a

a1_antitrypsin  aotlyTl ree,ga adn ehty gvie oyu a tsghli isreacne ni PT idnetas +1  
mambaforstep  ayeh ubt fi thye gaev yuo na aernecis in TPT then lmhepaoHii A uldco vhae ebne a ldvai awrens ceihoc. so heyt prob hseowd a nl TTP to dnitfeirfeaet vWF zd ofrm omhaipehl A +1  
drpee  VDW loyn mmoesiest rsnestpe whit a llhgtiys erecaisdn TP.T t'Dno etl ehtso niak tscaf retse oyu ong..wr. sluP lla eth roeth ewsasnr mkae no ee.nss nmafinAoiieber?g hatT sname elrlatlyi on ifbogrniin (PT nda TPT udlwo be eynfitlini einecar.ds) lmpHeoea?hi rO vaintim K cicef?eydni sTheo aer iglotocanua rfaoct drrdseois os heyt dowul repnets thiw dpee dlebnige and eargl .igburins inkelU( ltlapeet ridd,ossre ciglnduni D,VW ichwh speetrn thwi acoumsl bln,geedi aehepi,tec adn eyhva e)emns.s WVD is lylatauc hte OYNL eon atht emkas sees.n +10  
cbreland  I gte hyw sit' not iiaariegnonbmfe wc(hih is htaw I ekipcd), ubt lilts tdno' ansdntedur owh VDW si ri.hgt You haev marlno TPT nda lraomn epelattl ratiaggoneg bo(ht fo cwhhi lsuodh eb lnbaroa.m) sI the noly tinhg lndgaie us ot DVW si ti binge a pramiry bgdlenei ?siues inga,A ym eansrw mead no snse,e but VDW ni thsi tnotxc,e meess awy uot theer +4  
osteopathnproud  I raeeg whit oyu ndbc@lrea onec I edconti I adh to debn abl aelvsu rfo any sweanr eocihc tenh in my ehad tsmo fo meth eerw losb.sepi I okto a tesp kacb adn resawn iwth eht mots oomcnm dieegbnl eodrrsid, Wv es.ieasd nnyuF ghitn is wneh I erotok ti to ckhce my nasres,w I ahd tmei to etvhkonir dan otg it wgro.n +2  
aakb  eht anik tcfas revne rseet yuo wrgno! my akniz scdar ays oLw" vWF in onv irWldnlbea siaeesd iipsarm lattelep 1hic}:{ads"}n:oe{ p1(GB bnisd ot vW)F ont pltatlee grgnaitgoea IIGI(IapIb sbind to giboni).ernf onlladydiiat it yass ouy cna ehva etehir a ranmol ro iceasnre .PTT i n ihts seca the TP is tno .sairndcee It si eddaeercs a eti,llt chiwh I ssauem is enfi esp w na INR fo 1.0 +1  
lebabs  hStu up +6  
justanotherimg  i erega htwi dpee@r , nad ew olsa dene ot kepe ni ndim atth hdaehilxikme-nlo(ip evieessc)r ontw eb illyek in stih tpeitan a 20 ry old monwa +1  

submitted by โˆ—bwdc(664),
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nov erdblanWli aiedsse si by afr het otsm moomcn treidinhe eeinldgb es.hsaiitd l,yurFteeqn teh lnoy rayrbatloo bmaatlyoinr is randeecis ebnidegl mite (riellaylt oyu cpkir eth ntetapi and see owh ognl ti kaets hetm ot tpos ibnglede.) On ,eSpt bgldinee ewonm ehva .VWD eBedinlg bsyo avhe ai.iphhelom

winelover777  eegA.r TTP eods not aveh ot be deetvlae ot eb .VWD +6  
tulsigabbard  le.pW +1  
tekkenman101  Ecpxte setr'eh on aoratybolr riieedvf eibdlnge emit v,ieng loyn oengiagtrga cwihh ash to od ihtw ttatplee-lpleteal ni.oeritacnt +1  

submitted by canyon_run(4),
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hyw si eth ltlpaete gatgareoign etst si mralno ni ?WDV ym omprelb si atht bGp1 adn VfcotrWa ehav ot tniarcte ot udceni a nocfatlaiimrno cenahg ni alesettlp ot lseerea PAD &โ€“;tg PDA inbds ot pepad-rtecor nad iensdcu Ga2b3/p hiwch easnleb trioagggena iav i.biognefnr hwhci uwdol lade ot laanmbro rggatagioe?n dan is hte cetrnositi ayass nto a aletplet iaagnoergtg t?tes or can it tsomemeis be amnlor and smosmtiee nto?

bwdc  It can be blmoaarn sa e,llw pnededs on eht ubtyeps nda isvtreye (eth pkiiaeiwd egpa oesd a tnedce job ) hTe somt nomcmo tbsueyp fo VWD si a uaaitvteqnit tecedf, cihwh si ofnte aelld/yirmn ilniylcacl clctuo and can hvea lalensiyset marnlo raabolrtyo teit.gsn hsTi is eon of oseth sunqotsei heewr hte bsla era ylrela heetr ot exducel eth thoer ec.hciso +7  
chaosawaits  hTe ltetlpae nigeggratoa tset dan eht anorml TTP tseeedr em awya as ,elwl btu ehwn oyu knthi ouabt t,i VWD si a emrt ttah usdelnic a itrayev of nicedeisicef ahtt anc eb eherti tvqatieuinta or .tevlaqaitiu lAl het eohrt ostniop tleisd CNA'T be treu beasd on eth bla sulave nve.ig oS ihts oqsnueit semes to eb nsettig your tiyalbi to onwk chiwh siaesdes era iearlavb wthi alb aeuvsl nad hcwhi nac be yslaei luder tuo bdesa on lba vl.uaes +  

submitted by โˆ—jamespham93(1),

Pt shows classical signs of lack of platelet ADHESION. ADHESION is mediated by vWF. Platelet AGGREGATION studies test for AGGREGATION, which is mediated by fibrinogen, thus they have normal results on lab testing as they are not testing a pathway that uses vWF (very miniscule detail I know, very annoying).

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