sprint123
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Topics: 129
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A 7-year-old boy arrives at the emergency room in acute distress. Over the past 3 to 4 days he has become progressively ill with generalized fatigue and mild, mid-abdominal pain that have become steadily worse. On physical examination he has a maculopapular rash on his thighs and feet with some spread of the rash to his buttocks. The rash does not blanch and the some lesions near the ankles look petechial or bruised. His temperature is 39.0 C(102.2 F) and he is drawing his knees to his chest for relief of his stomach pains. He is nauseated and vomited once before coming to the hospital. He has semi-soft dark stool, which is guaiac-positive. The boy has not voided since early morning and cannot provide a urine sample. The doctor determines that he is 10% dehydrated and asks the nurse to start intravenous fluids. Which of the following is the most likely diagnosis?
A. Pancreatitis
B. Rocky Mountain spotted fever
C. Nephrotic syndrome
D. Henoch-Schönlein Purpura
E. Appendicitis
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| vradojc1
Forum Elite
Topics: 21
Posts: 309
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Looks like D
Vasculitis (rash doesn't bleach), distribution (buttocks/thighs) + abdominal pain due to GI involvement which in this case resulted in intususception.
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| silver
Forum Guru
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Posts: 774
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D. Henoch-Schönlein Purpura
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| Justice
Forum Fanatic
Topics: 101
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D. Henoch-Schönlein Purpura
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Don't live in a town where there are no doctors
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