Presentation

Bruising / Bleeding

Key Conditions

Key conditions are the core conditions that the Paediatric Undergraduate and Clerkship Directors of Canada (PUPDOC) felt are essential for graduating medical students to know. The Key Conditions are neither a differential diagnosis nor a clinical approach. They highlight conditions that may be unique to paediatrics, that are essential, or that are common. Key Conditions can present in a number of ways – each is listed as under the most common Clinical Presentation.

Clinical Approach

Clinical approaches represent one of many methods to think through a clinical presentation, and narrow down a differential diagnosis. There are many conditions that can present with similar symptomatology. These presentations are not meant to contain an exhaustive list of differential diagnoses, but rather outline how to think through patient signs and symptoms, and understand some of the most common and important Paediatric conditions. There are many different ways to approach any clinical presentation, and these approaches are not meant to replace clinical judgement.

Vignette

A 3 year old girl is brought to your clinic by her parents. They have noticed bruising, increasing epistaxis and bleeding in the gums that has worsened over the last 2 days

Diagrams

Pre-Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Lectures

Small Groups

  • Bleeding and Bruising Course 1

Clerkship

Lecture materials and small group cases are posted here for University of Calgary Cumming School of Medicine students. Access to these materials are password protected.

Objectives

By the end of the Paediatric Clerkship, a medical student will be able to:

  1. Identify the symptoms and signs of bleeding or clotting disorders.
  2. Describe the indications, contraindications and complications of blood products and their administration.
  3. Propose an investigation and management plan for a patient with Idiopathic Thrombocytopenic Purpura.
  4. Recognize the laboratory abnormalities for the following conditions
      • Hemophilia
      • Idiopathic Thrombocytopenic Purpura
      • Leukemia

Half Day Cases

  • A 3-year-old girl has a 2-day history of bruising, increasing epistaxis and gum bleeding
  • A 2-day old baby has bleeding from the umbilical stump
  • A 15-month old boy presents with a painful swollen right knee
  • A 13-year-old girl who presents with excessive menstrual bleeding, recurrent nosebleeds and pallor

Resources

The following resources have been reviewed and collated by canuc-paeds. These resources are aimed to provide information at the level of the medical student. These include overviews of topics, clinical resources, and useful guidelines that contain relevant materials.

Papers 

Videos 

No videos.

Clinical approaches to Bruising / Bleeding?

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Last updated 08 August 2021.