CLIPP 21

Question 1

what is the differential for bruising? (9)

Answer 1

coagulation disorder
HSP
ITP
Leukemia
Viral infection
Bacterial endocarditis
Meningococcal septicemia
RMSF
SLE

Question 2

What are common symptoms of HSP?

Answer 2

purpura on legs

arthralgia (knees)

abdominal pain

IgA nephropathy (1/3 of patients)

Question 3

what usuallu preceds HSP?

Answer 3

URI

Question 4

although treatment for HSP remains controversial, what treatment seems to help patients?

Answer 4

corticosteroids

Question 5

Is HSP self-limited?

Answer 5

yeah. it usually goes resolves in a month without treatment

Question 6

What are common findings/symptoms of intussusception? How is it treated?

Answer 6

abdominal pain, sausage-like mass, currant jelly

telescoped bowel is reduced by air or hydrostatic pressure; if unsuccessful, surgical intervention is required

Question 7

Is mottled skin okay in babies? Adults?

Answer 7

normal in babies (response to cold)

Not good in adults as it indicates probable pathology

Question 8

a kid presents with purpura on his legs. What lab value is essential to determine between HSP and ITP?

Answer 8

Platelets (non-thrombocytopenic is HSP, thrombocytopenic purpura is ITP)

Question 9

If a patient is suspected to have HSP, what labs to you order to determine if kidneys are involved?

Answer 9

UA (HSP can present with hematuria and/or proteinuria)

BUN and Cr (if hematuria or proteinuria are present to determine extent of renal disease)

Question 10

How do you differentiate HSP vs ITP vs leukemia?

Answer 10

HSP has a palpable spleen

ITP does not present with splenomegaly

Leukemia commonly presents with splenomegaly and bone pain