Purpuric eruption

Question 1

What are the four main causes of purpuric eruptions?

Answer 1

meningococcal septicaemia
DIC
Vasculitis
Senile purpura

Question 2

What are common sites of purpura in meningococcal septicaemia?

Answer 2

extremities

Question 3

what are associated features of most purpuric eruptions?

Answer 3

systemically unwell

Question 4

what is purpura?

Answer 4

purplish discolouration of the skin produced by small bleeding vessels near the surface

Question 5

What are petechiae?

Answer 5

purpura of less than 1cm diameter

Question 6

What are ecchymoses?

Answer 6

large extravasation of blood into the skin (bruise)

Question 7

What is the difference between purpura, petechiae and ecchymoses?

Answer 7

Petechiae are the smallest and ecchymoses are largest, Purpura is usually smaller than ecchymoses but larger than Petechiae.

Question 8

What causes acute DIC?

Answer 8

1. infection: sepsis, meningococcaemia, typhoid
2. Obstretric complications - placenta abruption, amniotic fluid embolism, eclampsia
3. Acute tissue injury - brain + crush injury, massive tissue destruction, necrotising entercolitis

Question 9

What are the causes of chronic DIC

Answer 9

1. Cancer
2. severe CTDs
3. chronic infections - TB, abscesses, osteomyelitis

Question 10

What is rx of acute DIC/

Answer 10

With bleeding: FFP, cryoprecipitate, platelet transfusions

With ischaemia: anticoagulants - heparin, LMWH after bleeding is corrected w blood products

Question 11

Wat is the rx of chronic DIC w/o thromboembolism?

Answer 11

prophylactic anticoagulants for those at high risk

Question 12

What is the rx of chronic DIC w thromboembolism

Answer 12

anticoagulant therapy e.g. LMWH

Trial of warfarin

Question 13

What is senile purpura? who does it most often occur in ?

Answer 13

common benign condition w recurrent purple bruises on extensor surfaces of forearms following minor trauma
usually