skip to main content

Immune thrombocytopenia — RACP Paediatrics MCQ

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

ModerateHaematology and oncologyImmune thrombocytopeniaRACP Paediatrics

A well 3-year-old has petechiae after a viral illness. Platelets are 12 x 10^9/L, haemoglobin and white cell count are normal, blood film shows large platelets and there is no hepatosplenomegaly. What is the most appropriate management?

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

Reveal the answer and explanation

Correct answer: A — Observation with bleeding advice if there is no significant mucosal bleeding

This is typical immune thrombocytopenia in a well child with isolated thrombocytopenia and normal film aside from large platelets; observation is appropriate when bleeding is mild. Platelet transfusion is reserved for serious bleeding or procedures because transfused platelets are rapidly destroyed. The pearl is that treatment decisions in ITP are driven by bleeding severity, not the platelet number alone.

Reference: RCH Clinical Practice Guidelines: Immune thrombocytopenic purpura; Therapeutic Guidelines (eTG)