The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A previously healthy 35-year-old primigravid woman at 12 weeks' gestation comes to the physician because of a fever, persistent headache, nausea, and abdominal discomfort for 1 week. During this time, she has also noticed that her gums bleed while brushing her teeth. A month ago, she returned from a camping trip to Sri Lanka. Her temperature is 39.3°C (102.8°F), pulse is 104/min, respirations are 24/min, and blood pressure is 135/88 mm Hg. Examination shows pallor and mild scleral icterus. There are a few scattered petechiae over the trunk and back. There is no lymphadenopathy. Physical and neurologic examinations show no other abnormalities. Test of the stool for occult blood is positive. Laboratory studies show: Hemoglobin 8.2 g/dL Leukocyte count 10,000/mm3 Platelet count 18,000/mm3 INR 1.0 Coomb's test negative Fibrin split products negative Serum Urea 20 mg/dL Creatinine 1.1 mg/dL Bilirubin Total 3.0 mg/dL Direct 0.8 mg/dL Alanine aminotransferase 20 U/L Aspartate aminotransferase 16 U/L Lactate dehydrogenase 900 U/L Urine Protein 1+ WBCs occasional RBCs 50–60/hpf Bacteria nil A photograph of the peripheral blood smear is shown. Blood and urine cultures are negative. Which of the following is the most likely diagnosis?"   (A) HELLP syndrome   (B) Thrombotic thrombocytopenic purpura   (C) Hemolytic uremic syndrome   (D) Autoimmune hemolytic anemia "
['(B) Thrombotic thrombocytopenic purpura <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) HELLP syndrome \n (B) Thrombotic thrombocytopenic purpura \n (C) Hemolytic uremic syndrome \n (D) Autoimmune hemolytic anemia\n" <> possible answers', '  A previously healthy 35-year-old primigravid woman at 12 weeks\' gestation comes to the physician because of a fever, persistent headache, nausea, and abdominal discomfort for 1 week. During this time, she has also noticed that her gums bleed while brushing her teeth. A month ago, she returned from a camping trip to Sri Lanka. Her temperature is 39.3°C (102.8°F), pulse is 104/min, respirations are 24/min, and blood pressure is 135/88 mm Hg. Examination shows pallor and mild scleral icterus. There are a few scattered petechiae over the trunk and back. There is no lymphadenopathy. Physical and neurologic examinations show no other abnormalities. Test of the stool for occult blood is positive. Laboratory studies show:\nHemoglobin 8.2 g/dL\nLeukocyte count 10,000/mm3\nPlatelet count 18,000/mm3\nINR 1.0\nCoomb\'s test negative\nFibrin split products negative\nSerum\nUrea 20 mg/dL\nCreatinine 1.1 mg/dL\nBilirubin\nTotal 3.0 mg/dL\nDirect 0.8 mg/dL\nAlanine aminotransferase 20 U/L\nAspartate aminotransferase 16 U/L\nLactate dehydrogenase 900 U/L\nUrine\nProtein 1+\nWBCs occasional\nRBCs 50–60/hpf\nBacteria nil\nA photograph of the peripheral blood smear is shown. Blood and urine cultures are negative. Which of the following is the most likely diagnosis?" <> context@']