Match each pediatric patient's clinical and laboratory presentation to the most likely underlying diagnosis and its associated pathophysiologic mechanism.
- A 4-year-old boy presents with sudden onset of petechiae and purpura two weeks after a mild viral upper respiratory infection. Labs: Platelets 18,000/mm³, normal PT, normal aPTT.Immune thrombocytopenia (autoimmune platelet destruction)
- A 14-year-old girl presents with heavy menstrual bleeding and a lifelong history of epistaxis. Labs: Normal platelets, normal PT, normal or slightly prolonged aPTT, prolonged bleeding time.Von Willebrand disease (deficiency of a platelet-endothelial adhesion protein)
- A 3-year-old boy is evaluated for recurrent swelling, warmth, and pain in his right knee after minor trauma. Labs: Normal platelets, normal PT, prolonged aPTT, normal bleeding time.Hemophilia A or B (deficiency of intrinsic pathway coagulation factors)
- A 6-year-old girl in the intensive care unit with meningococcemia develops oozing from her intravenous catheter sites. Labs: Platelets 45,000/mm³, prolonged PT, prolonged aPTT, decreased fibrinogen.Disseminated intravascular coagulation (widespread activation of the coagulation cascade)
Cevap
The clinical presentations correctly match their respective bleeding disorders based on the specific combination of coagulation study abnormalities and physical exam findings.
Each matching pair aligns a classic pediatric clinical vignette with its specific underlying hemostatic defect. ITP involves isolated platelet destruction; von Willebrand disease involves primary hemostasis defects with mucosal bleeding; Hemophilia causes deep tissue bleeding with intrinsic pathway defects; and DIC presents as a consumptive coagulopathy in a critically ill child.
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Anahtar Kavram
Diagnosis and Classification of Pediatric Bleeding Disorders