Petechiae and Purpura

Question 1

what is purpura?

Answer 1

red/purple color from extravasation of blood into skin or mucus membranes

Question 2

give the two types of macular purpura

Answer 2

ecchymoses and petechiae

Question 3

what is the difference between ecchymoses and petechiae

Answer 3

echhymoses are larger than 5 mm and petechiae are smaller than 3 mm

Question 4

is macular or palpable purpura a sign of vascular inflammation?

Answer 4

palpable purpura

Question 5

what can you do to determine if purpura is from vasodilation or erythrocyte extravasation?

Answer 5

diascopy

Question 6

what is a diascopy?

Answer 6

when you use glass to press on the redness

Question 7

if the redness goes away with diascopy and comes back what is the cause?

Answer 7

vasodilation

Question 8

if the redness remains with diascopy what is the cause

Answer 8

erythrocyte extrvasation

Question 9

give the three features of scurvy

Answer 9

petechiae
hemorrhagic gingivitis
vit C deficiency

Question 10

what two things are seen on skin with fulminant purpura?? and where on skin?

Answer 10

petechiae and large ecchymotic patches on extremities

Question 11

what often occurs with fulminant purpura?

Answer 11

DIC

Question 12

what is a common diagnosis that is the cause of fulminant purpura?

Answer 12

neisseria meningitidis leading to meningitis and sepsis

Question 13

what is the initial rash in RMSF?

Answer 13

faint macules on wrist and ankles

Question 14

what is the long standing rash with RMSF?

Answer 14

widespread petechiae on trunk extermities palms and soles

Question 15

what is the triad seen in RMSF?

Answer 15

fever rash and tick bite

Question 16

small vessel vasculitis leads to what on skin?

Answer 16

palpable purpura

Question 17

small to medium vessel vasculitis leads to what on skin?

Answer 17

subcutaneous nodules, purpura, livedo reticularis, and maybe ulceration/necrosis

Question 18

large vessel vasculitis leads to what on the skin?

Answer 18

claudication, ulceration and necrosis

Question 19

what is the small vessel vasculitis to know?

Answer 19

Henoch Schonlein purpura

Question 20

what are the small/medium vessel vasculitidies to know?

Answer 20

ANCA related…churg straus
micrscopic polyangitis
wegener granulomatosis

Question 21

what is the medium vessel vasculitis to know?

Answer 21

polyarteritis nodosa

Question 22

what is the large vessel vasculitis to know?

Answer 22

takayasu arteritis

Question 23

what should you do to work up a purpuric lesion?

Answer 23

skin biopsy

Question 24

what age gets henoch schenlein the most?

Answer 24

kids

Question 25

what antibody deposits in henlock schenlein?

Answer 25

IgA

Question 26

what can precede or cause henloch schenlein?

Answer 26

Strep infection

Question 27

what other organ system should you check in henloch schenlein?

Answer 27

the renal system

Question 28

how do you treat henloch schenlein?

Answer 28

supportive with maybe prednisone

Question 29

how does henloch schenlein appear on the skin? what are other manifestations?

Answer 29

palpable purpura with arthritis, kidney disease and abdominal pain

Question 30

how does polyarteritis nodosa appear on the skin?

Answer 30

multiple lower extremity erythematous subcutaneous nodules

Question 31

what is polyarteritis nodosa associated with?

Answer 31

HBV, HCV, HIV, and parvovirus b19

Question 32

what other manifestations can occur in polyarteritis nodosa?

Answer 32

fever renal involvement paresthesias

Question 33

what is treatment for polyarteritis nodosa?

Answer 33

mainly supportive...maybe prednisone