excessive bleeding in a child

[Asclepius1]

4 year old child is brought to you because of excessive bleeding, lab tests show decreased platelet count, increased bleeding time, normal PTT, and normal PT, what is the most likely diagnosis?

A. hemophilia A
B. vitamin K deficiency
C. von Willebrand's disease
D. idiopathic thrombocytopenic purpura

[Asclepius1]

Originally Posted by Anonymous

4 year old child is brought to you because of excessive bleeding, lab tests show decreased platelet count, increased bleeding time, normal PTT, and normal PT, what is the most likely diagnosis?

A. hemophilia A
B. vitamin K deficiency
C. von Willebrand's disease
D. idiopathic thrombocytopenic purpura

What is the gender of this child? Is it a male or a female? Some diseases are x-linked so it is good to know the gender.

[Asclepius1]

Originally Posted by Anonymous

What is the gender of this child? Is it a male or a female? Some diseases are x-linked so it is good to know the gender.

The baby is a male

[Asclepius1]

Prolong Bleeding time, low PLT, normal PT and PTT -- I will have to go with ITP. In kids, this pathology is normally self limited. This disease usually follows a viral infection. In most adults, it is a chronic disoder with no apparent predisposing cause.

[dradi]

answer is ITP

[doctorron]

Why ask about the gender of the child? You can answer this question by looking at the lab values. Normal PT and PTT means that this is NOT a
coagulation factor disorder, thus the answers are NOT vit K deficiency
or Hemophilia A. Its NOT vWF disease b/c the pt has thrombocytopenia. Thus the only answer left is ITP which would give u thrombocyopenia. Remember guyz, for the boards, is NOT always about figuring out the right answer but rather about eliminating the wrong answers.

[student-2]

If not for the thrombocytopenia i would have gone with vW... There was no mention to other characteristics which are much more visible in a child with ITP- severe bleeding in ITP is when the PLT number is pretty low- may even require PLT transfusion at such a level. Usually ITP presents earlier with non-palpable purpura and minor excessive bleedings of gums etc. When I hear excessive bleeding- I try and understand how excessive