CLIPP 21

Question 1

ITP

Answer 1

asymptomatic petechiae. A nonspecific URI precedes cases more than 50% of the time.

Question 2

fever, fatigue and weight loss - usual presenting complaints for___

Answer 2

endocarditits

Question 3

LN > ___ cm are concerning

Answer 3

2

Question 4

in normal newborns, the liver edge may be palpable up to __ cm below the costal margin. In older children, it may be palpable up to __ cm below the costal margin (though typically not more than 1 cm).

Answer 4

3.5, 2

Question 5

arthralgia vs arthritis

Answer 5

arthralgia  = pain in/around joint w/o signs of synovitis
arthritis = true synovitis (joint pain or joint swelling with limitation of ROM on exam)

Question 6

rash in HSP

Answer 6

purpora of lower extremities

Question 7

is there splenomegaly in HSP?

Answer 7

no

Question 8

is there splenomegaly in ITP?

Answer 8

no

Question 9

A spleen edge felt more than _cm below the left costal margin is considered abnormal.

Answer 9

2 cm

Question 10

key lab difference in HSP vs ITP

Answer 10

HSP is non thrombocytopenic

Question 11

hsp sx

Answer 11

kidney damage (i.e. may see blood in UA and is linked to IgA Nephropathy), arthraglia, purpuric rash, abd pain

Question 12

most common vasculitils in kids

Answer 12

hsp

Question 13

non thrombocytpenic purpura

Answer 13

hsp

Question 14

tx for hsp vs itp

Answer 14

hsp - mostly supportive. lasts a month or so and self resolves. steroids can sometimes be used..
itp - can include steroids, obvs, ivig, rhogam (anti D ig)

Question 15

most common form of bowel obstruction in kids and it happens at __ age

Answer 15

intussuceptin, between 6 months to 6 y`

Question 16

where does intussception in HSP start

Answer 16

likely begins at points of intestinal edema or submucosal hemorrhage. most IDIOPATHIC cases are at ileuocecal junction

Question 17

classic intussuception triad

Answer 17

abd pain w/ crying, current jelly stool w/ blood and mucus, sausage mass in right abd

Question 18

standard approach to intussuception dx and tx in idiopathic vs hsp-related

Answer 18

air or barium enema, sometimes US. then reduce teleopsced segment of bowel with hydrostatic pressure, rarely surgery but often surg in HSP bc telescoping in HSP is ileo-ileal.

Question 19

age in which to use FACES pain scasle

Answer 19

3 or older

Question 20

initial sx in first hsp episode vs recurrnce

Answer 20

intial = rash
recurrence= abd pain

Question 21

how can anemia manifest

Answer 21

pallor, fatigue, tachycardia

Question 22

sudden change in BP can indicate

Answer 22

change in renal fxn

Question 23

if serum IgA elevated, consider

Answer 23

hsp