spot the sign

Question 1

what is pallor

Answer 1

unusual lightness (paleness) of skin colour

Question 2

what causes pallor and where can it occur

Answer 2

May be caused by reduced blood flow and hypoxia or decreased RBC level
It can occur all over the skin or be localised (affect one limb)

Question 3

pallor - DDx

Answer 3

anaemia
cancers
shock
frostbite
hypoglycaemia
 panic attacks
migraine attacks
emotional response (fear)
peripheral vascular disease

Question 4

what is purpura

Answer 4

Occurs when small blood vessels burst and blood pools underneath the skin.
They appear as small purple spots beneath the skin’s surface.

Question 5

difference between petichiae, purpura and ecchymoses

Answer 5

Petechiae are <3mm and purpura 4-10mm in diameter.
Larger patches of bruising >1cm are called ecchymoses.
Sometimes the spots can appear on mucous membrane (inside the mouth)

Question 6

where does purpura tend to occur

Answer 6

Purpura tends to occur in clusters in a single area or cover a large portion of the body.
They are most common in the lower legs or under areas of friction.

Question 7

do purpura blanch

Answer 7

There should be no itch or irritation nor should purpura change colour/ blanch when pressed.

Question 8

2 categories of purpura

Answer 8

Thrombocytopenic purpura- arises from low platelet counts

Nonthrombocytopenic purpura- normal platelet levels. Rarer

Question 9

causes of thrombocytopenic purpura

Answer 9

bone marrow diseases, chemotherapy, ITP, congenital platelet disorders

Question 10

causes of nonthrombocytopenic purpura

Answer 10

a variety of non-platelet causes such as amyloidosis and scurvy- often involving abnormalities of the blood vessels

Question 11

what to look out for in purpura

Answer 11

Vasculitis-> the rash looks like purpura but is blanchable

Steroids/ age related blood vessel deterioration-> cause ecchymoses rather than purpura