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What is the most concerning statement by a child with a newly placed long leg cast after repair of the tibia?

The correct answer is c. An excessive destruction of platelets.

Choice A: Diffuse fibrin deposition in the microvasculature

Diffuse fibrin deposition in the microvasculature is not characteristic of immune thrombocytopenia (ITP). This description is more aligned with disseminated intravascular coagulation (DIC), a condition where widespread clotting occurs within the blood vessels, leading to multiple organ damage.

Choice B: Deficiency in the production rate of globin chains

A deficiency in the production rate of globin chains is associated with thalassemia, a genetic blood disorder that affects the production of hemoglobin. This is not related to the pathology of immune thrombocytopenia.

Choice C: An excessive destruction of platelets

An excessive destruction of platelets is the hallmark of immune thrombocytopenia (ITP). In ITP, the immune system mistakenly targets and destroys platelets, which are essential for blood clotting. This leads to a low platelet count and an increased risk of bleeding.

Choice D: Bone marrow failure in which all elements are suppressed

Bone marrow failure in which all elements are suppressed is characteristic of aplastic anemia, a condition where the bone marrow fails to produce sufficient blood cells. This is not related to immune thrombocytopenia.

Choice A reason:

I will have my child rest: Resting is an important part of managing a bleeding episode in children with hemophilia. It helps to minimize movement and reduce the risk of further injury or bleeding.

Choice B Reason:

I will compress the site: Applying pressure to the bleeding site is a standard first aid measure for controlling bleeding. Compression helps to slow down or stop the bleeding by promoting clot formation.

Choice C Reason:

I will apply heat: Applying heat is not recommended for managing bleeding in hemophilia. Heat can increase blood flow to the area, potentially worsening the bleeding. Instead, cold compresses or ice packs should be used to constrict blood vessels and reduce bleeding.

Choice D Reason:

I will elevate the affected part: Elevating the affected limb can help reduce blood flow to the area and minimize bleeding. This is a common and effective first aid measure for managing bleeding episodes.