American Board of Internal Medicine (ABIM) Certification Practice Exam

In patients diagnosed with essential thrombocythemia, what additional medication is often recommended alongside hydroxyurea?

1. Low-dose aspirin

2. Clopidogrel

3. Warfarin

4. Statins

The correct answer is: Low-dose aspirin

In patients diagnosed with essential thrombocythemia (ET), the addition of low-dose aspirin to the treatment regimen alongside hydroxyurea is often recommended. This is due to the thrombotic risk associated with ET, where patients have elevated platelet counts that can contribute to increased blood viscosity and potential cardiovascular events. Low-dose aspirin works as an antiplatelet agent, helping to reduce the risk of thrombotic complications such as strokes or heart attacks. It does this by inhibiting platelet aggregation, thereby decreasing the likelihood of blood clots forming in the microcirculation. The use of hydroxyurea helps to lower the elevated platelet count, but low-dose aspirin addresses the thrombotic risk from another angle, providing a complementary approach to management. This combination is particularly valuable in patients who have experienced thrombotic events or have additional risk factors for thrombosis, as it enhances overall treatment effectiveness and patient safety.