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I Saw Red

Morning Report

March 6, 2006Nita Mohanty

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History: 3 yo Male with

PERTINENT POSITIVES

URI sx x 1 week

Hematuria Rash: Bruising

Epistaxis

Sore Throat

Sick Contacts: Mom w/ StrepThroat, Dad and Sister w/Scarlet fever school contact

Finger pain x 2 days

OTC meds: Decongestant x 1wk

PERTINENT NEGATIVES

Abdominal Pain

Joint Pain Headache

Weight Loss

Diarrhea or Emesis

Extremity or Periorbitalswelling

Travel

Drug Exposure

Trauma

No easy bruisability, bleedinggums

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Physical Exam

Vitals: T: 36.9 HR: 123 RR: 16 BP: 101/54 98% RA

Gen: sitting up, smiling, coloring, NAD

HEENT: crusted blood at L nares, + palatal petechiae,+erythematous post. pharynx w/ mild tonsillar exudates

small papule noted at L nostril, no conjunctival or retinalhemorrhage

Lymph: nontender, submand LAD app. 1.5 cm bilaterally, noaxillary or inguinal LAD

CV: RRR, No murmur

Chest: CTA, no W/R/R

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Labs and Imaging

CBC: WBC: 13.2 Hgb: 10.2 Hct: 28.6 Plts:3

Retic: 1.7% N61 B28 M6 E4 B1

BMP: Na: 140 K: 3.6 Chl: 100 CO2: 28 BUN: 17 Cr: 0.3

LFTs: TP: 7.6 Alb: 4.3 Bili: 0.3 SGOT: 32 SGPT: 18 PT: 13.3 INR: 1.0

UA: Sp.G: 1.024, 4+ Blood, 1+ Protein, RBCs > 20 per

HPF CXR: Normal Chest, no mediastinal masses

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Our Diagnosis Is..

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Idiopathic ThrombocytopenicPurpura

Morning Report

March 6, 2006Nita Mohanty

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Background and Epidemiology

Acquired Hemorrhagic Disorder with: Thrombocytopenia: Platelet count