American Board of Internal Medicine (ABIM) Certification Practice Exam

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What triggers the need for a platelet transfusion for febrile infections according to guidelines?

The correct answer is: 20K

Platelet transfusions for patients with febrile infections are typically guided by the platelet count and the clinical situation of the patient. The guideline threshold for initiating a platelet transfusion in patients experiencing febrile neutropenia or severe infections is usually around a platelet count of 20,000 cells per microliter. This specific threshold is used because a platelet count at this level can lead to a higher risk of bleeding, especially in the context of infections which may also present with other complications that exacerbate bleeding risk. Maintaining a higher platelet count can aid in preventing complications such as spontaneous bleeding, which is particularly concerning in patients who may already be experiencing bleeding risks due to both their underlying conditions and potential treatments. Setting the threshold at 20,000 cells per microliter balances the risk of bleeding with the resources required for transfusion, allowing for timely intervention in cases where patients may have additional risk factors for hemorrhage, creating a proactive approach to management.