Review Note
Last Update: 06/10/2024 12:17 AM
Current Deck: SLS Cards::10. Pediatric growth and nutrition
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Commit #107663
What is your DDx for a child with unexplained bruising?
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Commit #107663Common
- Accidental injury (more common on bony prominences)
- NAI (sus patterns, inconsistent story, multiple stages of healing)
Hematologic
- Primary coagulopathy
- VWD (mucosal bleeding, FHx)
- Immune thrombocytopenic purpura (ITP; usually post-viral infection, thrombocytopenia)
- Thrombocytopenic purpura (TTP)
- Secondary coagulopathy
- Hemophilia
- Other factor deficiencies
- Malignancy
- Acute lymphoblastic leukemia (ALL; pallor, fatigue, petechiae, hepatosplenomegaly, bone pain)
Infectious
- Meningococcal septicemia (rapid onset, fever, petichiae, purpura)
- Viral infections
- Rubella, measles (rash, possibly with bruising)
- EBV (can cause thromobytopenia)
Metabolic and genetic
- Connective tissue
- Ehlers-Danlos (hyperextensible skin, joint hypermobility)
- Marfan (tall stature, cardiovascular anomalies)
- Nutritional
- Vit C def (perifollicular hemorrhage, gingival bleeding)
- Vit K def (bleeding tendencies)
Other
- Liver dyfunction
- Renal dysfunction
- Medications (NSAIDs, corticosteroids, antigcoagulants)
- Mongolian spot/ congenital dermal melanocytosis (lower back, buttocks, NOT actually bruising)