skip to main content

Henoch-Schonlein purpura — USMLE Step 2 CK MCQ

Instant feedback + full explanation. One question, done properly.

HardPediatricsHenoch-Schonlein purpuraUSMLE Step 2 CK

A 6-year-old has palpable nonblanching purpura on the legs and buttocks, ankle arthralgia, and intermittent abdominal pain 1 week after an upper respiratory infection. Platelet count and coagulation studies are normal. Blood pressure and creatinine are normal, and urinalysis shows microscopic hematuria without substantial proteinuria. Which plan is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Use supportive care with serial blood pressure, urinalysis, and renal-function monitoring

The best answer is “Use supportive care with serial blood pressure, urinalysis, and renal-function monitoring”. This presentation is IgA vasculitis with mild renal involvement; most children need supportive treatment, but renal disease can emerge or worsen after rash resolution, so surveillance continues for at least six months. Prednisone is not routinely used to prevent nephritis. Cyclophosphamide and biopsy are reserved for substantial or progressive renal disease.

Reference: NIDDK: IgA vasculitis. https://www.niddk.nih.gov/health-information/kidney-disease/iga-vasculitis