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OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is Henoch-Schönlein purpura (Henoch-Schonlein purpura). While this may seem a odd practice, it is useful to see multiple examples of how Henoch-Schönlein purpura (Henoch-Schonlein purpura) will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)
When it comes to standardized exams, each condition has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for Henoch-Schönlein purpura.
- Young age: patients are typically <15 years of age
- Recent history of infection: upper respiratory infections are common.
- Abdominal pain is common. Can be a trigger for intussusception in children
- Arthralgias can be present as well
- Palpable purport is seen on the skin.
- Hematuria/proteinuria can be detected in the urine
- Normal platelets/coagulatoin studies: this will help differentiate it form other conditions that can cause purpura
QUESTION EXAMPLES
Question # 1
A 9 year old boy is brought to the hospital by his mother because he has had a rash on his legs for the past day. His mother explains that he also had a viral illness about a week earlier. The patient also complains of abodminla pan and nausea as of yesterday. There is no recent travel history, and there are no known sick contacts. The patient has no notable past medical history, has no allergies, and is up to date with his immunizations. His temperature is 98.7°F, blood pressure is 125/75 mm Hg, and heart rate is 84/min. A physical exam reveals an abdomen that is soft with mild, diffuse tenderness to deep palpation. There is no rebound tenderness or guarding during the exam. There is non blanching, palpable purple lesions below the knees bilaterally, and there is also midl swelling of both feet. The rest of the exam is non-contributory. Lab studies are shown below:
Complete blood count:
- Hemoglobin: 12.9 g/dL
- Platelets: 160,000/µL
- Leukocytes: 8,000/µL
Urinalysis:
- Specific gravity: 1.024
- pH: 6.9
- Protein: 1+
- Blood: moderate **
- Glucose: negative
- Ketones: negative
- Leukocyte esterase: negative
- Nitrites: negative
- Bacteria: none
- White blood cells: 1-2/hpf
- Red blood cells: 20-25/hpf
What diagnosis may explain this presentation?
Explanation: abodminla pain + palpable purpura + hematuria = Henoch-Schönlein purpura (Henoch-Schonlein purpura)
TESTABLE FACTS ABOUT THIS CONDITION (BEYOND ITS IDENTIFICATION)
Many questions on standardized exams go beyond simply recognizing the underlying condition. Often there are specific testable facts regarding some aspect of the disease’s pathophysiology/management/clincial implications that are commonly asked. Some of these are listed below:
- Cause: IgA immune complex mediated vasculitis (generally follows upper respiratory or other minor function).
- Glomerular findings: mesagnial deposition fo immunoglobulin A (very similar to IgA nephropathy)
Page Updated: 11.25.2016