Immune Thrombocytopenia – Board-Style Questions

Immune Thrombocytopenia — Board-Style Questions
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Pediatric Case ReviewBoard-Style Questions
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What this deck covers

Immune Thrombocytopenia in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

  1. What the smear should show
  2. Thirteen and no preceding illness
  3. Seven months on
  4. Due his pre-school jab
  5. Waking with sore legs
  6. Chest infections too
  7. Will treating now make a difference
  8. How long on the tablets
  9. Theatre in the morning
  10. Headache the day after
  11. Quick and cheap, but
  12. Blood in the vomit
  13. Taken with the morning meal
  14. They read about an operation
  15. Wanting the school team
  16. The question they fear most
  17. Cramps and heavy periods
  18. Her mother’s condition

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Red cell fragments with polychromasia, It makes remission within a few weeks almost certain, Persistent immune thrombocytopenia, Never give it, as the reaction contraindicates it, A direct antiglobulin test, then steroid if negative, Serum IgG, IgA and IgM levels, Six weeks at full dose for lasting remission, Immunoglobulin infusion, A lumbar puncture to confirm aseptic meningitis, It works only in children who have had a splenectomy, Antibodies have formed against the drug itself, Give rituximab first, then operate within the month, Keep him out of all sport until his count is normal, About twenty in every hundred children.

Clinical pearls from this deck

  • Immune thrombocytopenia has a quiet film: few platelets, some big, nothing else wrong.
  • The older the child and the slower the onset, the more ITP behaves like the adult form.
  • Under three months new, three to twelve persistent, over twelve chronic.
  • ITP after the first MMR: test the antibodies before the second, then protect him if needed.
  • ITP affects one cell line in a well child; anything more means marrow first.
  • Chronic ITP plus chest infections: check the immunoglobulins before anyone infuses them.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all Haematology case decks · pediatric reference values.

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