Haematology: ITP: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Haematology: ITP

Sample item

A 4-year-old well child has widespread petechiae and bruising for 3 days after a viral illness. Haemoglobin and white cell count are normal, the platelet count is 18 × 10^9/L, and there is no mucosal bleeding or organomegaly. What is the usual management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Observation with advice to avoid trauma, as most resolve spontaneously

Immune thrombocytopenia of childhood is usually self-limiting after a viral infection. If there is no significant bleeding, observation is acceptable even with low counts, with advice on avoiding trauma and contact sports. IVIG, short-course steroids or anti-D are used if there is significant mucosal bleeding. A marrow is only needed if the picture is atypical.

Option by option

  • A. Immediate splenectomy

    Splenectomy is reserved for chronic, refractory cases after many months.

  • B. Observation with advice to avoid trauma, as most resolve spontaneously (correct)

    Correct. Children without significant bleeding can be observed.

  • C. Platelet transfusion

    Transfusion is for life-threatening bleeding, since the platelets are rapidly destroyed.

  • D. Chemotherapy

    Chemotherapy is not indicated for ITP.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pediatrics questions

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Observation with advice to avoid trauma, as most resolve spontaneously. Immune thrombocytopenia of childhood is usually self-limiting after a viral infection.

Why is "Immediate splenectomy" not the answer?

Splenectomy is reserved for chronic, refractory cases after many months.

Why is "Platelet transfusion" not the answer?

Transfusion is for life-threatening bleeding, since the platelets are rapidly destroyed.

Why is "Chemotherapy" not the answer?

Chemotherapy is not indicated for ITP.

What concept does this question test?

It tests Haematology: ITP in Pediatrics. If there is no significant bleeding, observation is acceptable even with low counts, with advice on avoiding trauma and contact sports. IVIG, short-course steroids or anti-D are used if there is significant mucosal bleeding. A marrow is only needed if the picture is atypical.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematology: ITP?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.