Bleeding & Bruising DDx

Bleeding & Bruising – Differential Diagnosis

Common causes

• Trauma
• Age related purpura

Must Not Miss

• Liver disease
• Haematological disease
  • Lymphoma
  • Leukaemia
  • Multiple myeloma
  • Aplastic anaemia
  • Thrombocytopenic purpura
• Sepsis
• Coagulation disorders

Easily missed

• Medication
• HSP
• Vitamin K deficiency
• Vitamin C deficiency
• Connective tissue diseases

Red flags

• Sepsis
• Petechial rash of meningitis
• Systemic symptoms
  • (fever, weight loss, lethargy, bone pain)
• Symptoms of anaemia

Investigations to consider

• FBC + film, CRP/ESR, clotting screen
• U+Es, LFTs, LDH
• Myeloma screen
• Auto-antibody screen
• Urinalysis
• CXR
• CT scan (Head, chest, abdomen & pelvis)
• Lumbar Puncture
• Bone scan
• Bone marrow analysis