A 4-year-old boy develops widespread bruising on his shins and trunk and a crop of pinpoint red spots on his legs over three days, two weeks after a cold. He is otherwise well, playing normally, with no fever, bone pain or lethargy. Examination shows no pallor, no lymphadenopathy and no hepatosplenomegaly; there is no bleeding from the gums or nose. Full blood count: haemoglobin 124 g/L, white cell count 7.9 × 10⁹/L with a normal differential, platelets 11 × 10⁹/L; the blood film shows large platelets and no abnormal cells.
Which one of the following is the most appropriate management?
Keep going — a set of ten like this one, one at a time.
Practise moreMore from Paediatrics
See allA couple attend for genetic counselling. Their 3-year-old son has cystic fibrosis, confirmed by newborn screening and genotyping; both parents are carriers of a…
Foundations · common
A 10-day-old boy born at term is brought in with two days of poor feeding, vomiting and lethargy, and today is floppy and grey. He is afebrile, with a heart rat…
Clinical rotations · niche
A 2-year-old boy weighing 12 kg has had two days of vomiting and profuse watery diarrhoea. He is now floppy and barely responsive, with cool mottled legs, a cap…
Clinical rotations · common
A 9-month-old girl was eating grapes when she suddenly began to struggle. When you reach her she is conscious, silent, not crying and not coughing, with her mou…
Clinical rotations · common
A 3-year-old girl has refused to walk or stand since waking this morning and screams when her right leg is moved. She had a cold last week. Her temperature is 3…
Pre-internship · common