GI

Question 1

What is HSP?

Answer 1

Systemic IgA vasculitis

Question 2

What are the sx of HSP?

Answer 2

Rash: non-blanchable purpura or palpable macules on extensor surface of LL & buttocks
Arthritis (LL)
Renal: nephrotic syndrome, nephritis, chronic renal failure
Abdominal pain: gut wall hemorrhage/edema, intussusception, ileus, pr-losing enteropathy, orchitis, testicular torsion

Question 3

What is the cause of HSP?

Answer 3

Unknown, but often preceded by URTI (increases serum IgA -> deposit in vessels)

Question 4

How to investigate HSP?

Answer 4

Cause:

• Blood: normal plt (r/o ITP), low C3/C4, RFT, AI markers (r/o JIA)
• ASOT, throat swab

Cx:

• Urine dipstick -> UPCR
• USG abdomen
• Renal biopsy

Question 5

How to manage HSP?

Answer 5

Symptomatic: NSAID, bed rest
Severe: corticosteroids
Surg

Question 6

What is the peak age of intussusception?

Answer 6

3m-3y

Question 7

What are the causes of intussusception?

Answer 7

Idiopathic
Viral: enteric inf, oral vaccine
Structural: polyp, diverticulum
HSP

Question 8

What are the S/S of intussusception?

Answer 8

Bilious vomiting
Red currant jelly stool
Sausage shaped mass on palpation

Question 9

How to Ix intussusception?

Answer 9

USG: target sx
AXR: distended bowel loops +/- absence of colonic gas, meniscus sx

Question 10

What are the Cx of intussusception?

Answer 10

Ischemia, perforation, peritonitis
Hypovolemic shock (venous congestion)

Question 11

How to Mx intussusception?

Answer 11

IVF
Non-operative: fluoroscopic-guided pneumatic / hydrostatic reduction by enema
Operative reduction