Paediatric: History taking & Physical examination of Henoch-Schonlein Purpura (HSP)

Paediatric: History taking & Physical examination of Henoch-Schonlein Purpura (HSP)Created OnApril 22, 2020Last Updated OnApril 22, 2020byadmin You are here: Main Clinical Examination Paediatric: History taking & Physical examination of Henoch-Schonlein Purpura (HSP) < All Topics Table of Contents History taking: Ask about patient’s information – name, age, gender, race and ethnicity Ask about chief complaints, commonly presenting with rash, joint pain and abdominal pain, including illness duration Ask about history of presenting illness Rash: onset, distribution pattern, itching, discharges, blistering Joint pain: SOCRATES, morning stiffness, gelling, restricted mobility, Abdominal pain: SOCRATES Ask for the following symptoms associated with HSP: Scrotal pain or swelling Anorexia Nausea and vomiting Hematemesis Fever Headaches (rare) Seizures (rare) Reduced level of consciousness Chest pain (myocardial infarction) Diarrhoea and bloody stool (GI involvement) Subcutaneous oedema Ask about past medical/surgical history Ask for any recent history of URTI (often precedes HSP) Ask about drug history History of taking certain medications such as penicillin, cefaclo, minocycline, hydralazine and phenytoin, which may precipitate HSP Ask about immunization history Ask if the patient has completed the immunization accordingly Explore if there is any adverse reaction caused by previous vaccination Vaccines such as typhoid, measles, yellow fever and cholera may precipitate HSP Ask about feeding history Ask about family history Ask about social history Ask about systemic review Physical examination: General examination Assess the vital signs Blood pressure may be elevated due to renal involvement Increased respiratory rate (due to pulmonary haemorrhage or pleural effusion secondary to renal disease) Temperature maybe increased Palpate the radial pulse for rhythm, rate and characteristic Assess pain score Assess oxygen saturation with pulse oximeter Look for skin rash: Usually begins as erythematous macular or urticarial lesions, progressing to blanching papules then later to palpable purpura (2-10 mm in diameter, non-blanching on pressure) May occur anywhere but usually with lower limbs predominance Usually occurs in crops and fades over several days Look for features of renal diseases Anaemia Sallow appearance of the face Puffy eyes or face due to oedema Limbs oedema Abdominal examination Hepatosplenomegaly Palpable gall bladder (hydrops of gallbladder) Tenderness Ascites (renal...

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