A 12-year-old girl presents with bleeding gums while brushing her teeth, starting 1 week ago after a viral upper respiratory tract infection. Physical examination reveals petechiae... A 12-year-old girl presents with bleeding gums while brushing her teeth, starting 1 week ago after a viral upper respiratory tract infection. Physical examination reveals petechiae on extremities and abdomen. There is no lymphadenopathy or hepatosplenomegaly. Lab results: Hb 130 g/L, HCT 0.39, MCV 88 f1, WBC 8 x 109/L, Platelets 20 x 109/L. Bone Marrow: Increased megakaryocytes. Which of the following is the most appropriate management? A. Azathioprine B. Prednisolone C. Splenectomy D. Cyclophosphamide
Understand the Problem
The question describes a clinical scenario of a 12-year-old girl presenting with bleeding gums and petechiae after a viral infection. Lab results show a significantly low platelet count (thrombocytopenia) with normal hemoglobin, hematocrit, and white blood cell count. Bone marrow examination reveals increased megakaryocytes, indicating that the bone marrow is attempting to compensate for the low platelet count. The question asks us to select the most appropriate management option based on the given information. This is a question about how to manage a case of acute thrombocytopenia, most likely immune thrombocytopenic purpura (ITP).
Answer
Prednisolone
The most appropriate management is Prednisolone. The patient likely has immune thrombocytopenic purpura (ITP).
Answer for screen readers
The most appropriate management is Prednisolone. The patient likely has immune thrombocytopenic purpura (ITP).
More Information
The clinical vignette describes a patient with signs and symptoms suggestive of immune thrombocytopenic purpura (ITP). This diagnosis is supported by the recent viral infection, bleeding gums, petechiae, low platelet count, and increased megakaryocytes in the bone marrow. First-line treatment for ITP often involves corticosteroids like prednisolone to increase platelet count.
Tips
A common mistake is to confuse ITP with other thrombocytopenic conditions. Remember that in ITP, the bone marrow is typically normal with increased megakaryocytes, whereas in other conditions, the bone marrow may show different abnormalities.
AI-generated content may contain errors. Please verify critical information
