USMLE Forum Archives - USMLE Step 2 CK - Peds 8
Peds 8
TheOne - 02-23-07 18:15
6 years old boy is brought to the emergency department in acute distress. His parents explain that over the past 3 days he has become progressively ill with generalized fatigue and mild, mid-abdominal pain that have become steadily worse. On physical examination he has a maculopapular rash on his thighs and legs with some spread of the rash to his buttocks. The rash does not blanch and the some lesions near the ankles look petechial or bruised. His temperature is 38 C (101.2 F) and he is drawing his knees to his chest for relief of his stomach pains. He is nauseated and vomited twice before coming to the hospital. He has semi-soft dark stool, which is positive for occult blood. The boy has not voided since early morning and is unable to provide a urine sample. The physician determines that the boy is 10% dehydrated and asks the nurse to start intravenous fluids. Which of the following is the most likely diagnosis?
A. Pancreatitis
B. Rocky Mountain spotted fever
C. Henoch-Schönlein Purpura
D. Nephrotic syndrome
E. Appendicitis
TheOne - 02-23-07 18:15
6 years old boy is brought to the emergency department in acute distress. His parents explain that over the past 3 days he has become progressively ill with generalized fatigue and mild, mid-abdominal pain that have become steadily worse. On physical examination he has a maculopapular rash on his thighs and legs with some spread of the rash to his buttocks. The rash does not blanch and the some lesions near the ankles look petechial or bruised. His temperature is 38 C (101.2 F) and he is drawing his knees to his chest for relief of his stomach pains. He is nauseated and vomited twice before coming to the hospital. He has semi-soft dark stool, which is positive for occult blood. The boy has not voided since early morning and is unable to provide a urine sample. The physician determines that the boy is 10% dehydrated and asks the nurse to start intravenous fluids. Which of the following is the most likely diagnosis?
A. Pancreatitis
B. Rocky Mountain spotted fever
C. Henoch-Schönlein Purpura
D. Nephrotic syndrome
E. Appendicitis
Page 1
#3
Re: Peds 8 HIV - 03-02-07 17:49 HI theone I really like your Q.I am studying for usmle step2.I did step1.so,HOw about you MR/mis theone
#4
It's Dr.TheOne :-)
TheOne - 03-07-07 08:29 The correct answer is C. Henoch- Schönlein Purpura is the most likely diagnosis. This boy has abdominal pain with guaiac-positive stools, but also has a prominent rash, mostly on his lower extremities. Other characteristic findings of HSP include hematuria and joint pains. The illness may follow an upper respiratory infection or strep throat. The rash starts out as an urticarial rash and progresses to become petechial and purpuric. There may be a history of migratory joint pain and arthritis. Affected joints include ankles, knees, wrists, and elbows.
Buzz Words: Child + Abd. pain + Rash / hx of URI or GI.
#6
Re: Peds 8 babbu5508 - 07-06-10 23:03 C. Henoch-Schönlein Purpura.Typical symptoms include palpable purpura (small hemorrhages in the skin), joint pains and abdominal pain.
#7
Re: Peds 8 bingousmle - 07-09-10 14:47 Henoch-Schonlein purpura (HSP) - an immunologically mediated, nonthrombocytopenic, purpuric, and systemic vasculitis involving the small blood vessels of the skin, gastrointestinal (GI) tract, joints, and kidneys.
Page 1