Questions Your Doctor May Ask - and Why!
During a consultation, your doctor will use various techniques in his assesment of the symptom: Bruising.
These may include a physical examination or other medical tests.
Your doctor may ask several questions when assessing
your condition. It is important to remember that your consultation is a two-way process and any extra information
you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
- How long have you had the bruising ?
Why: determines if acute or chronic; acquired or inherited.
- Type of bruising under the skin?
Why: purpura ( multiple small hemorrhages into the skin or mucous membranes); petechiae (small pinhead size purpura); ecchymoses ( large purpura).
- If petechiae are present, are they palpable?
Why: if palpable it suggests due to an underlying vasculitis affecting small vessels e.g. polyarteritis nodosa; if not palpable it suggests due to a platelet defect.
- Is bruising abnormal and out of proportion to the offending injury?
Why: suggests a disturbance of coagulation.
- Is bruising spontaneous?
Why: suggests the presence of a systemic bleeding defect.
- Does bruising occur immediately after trauma or is it delayed?
Why: if immediate suggests platelet defect; if delayed i.e. 24 hrs after trauma it suggests a coagulation factor deficiency.
- What has been the response to previous coagulation stresses?
Why: e.g. tooth extraction, circumcision, pregnancy - if normal response, suggests an acquired not inherited problem.
- Did you notice a viral illness or sore throat beforehand?
Why: may suggest acute Immune thrombocytopenic purpura (ITP) especially in children.
- Domestic violence or child abuse?
Why: may suggest trauma as cause of bleeding under skin.
- Past medical history?
Why: Acquired bleeding disorders can occur with liver disease, renal failure, lupus erythematosus and some cancers such as Multiple myeloma, myelofibrosis.
- Medications?
Why: Acquired bleeding disorders may be due to certain prescribed medications e.g. aspirin, non-steroidal anti-inflammatory medication, anticoagulant therapy, thiazide diuretics, chloramphenicol, cancer chemotherapy drugs, gold, heparin, quinine, quinidine, sulphonamides.
- Family history of bleeding symptoms/ bleeding disorders?
- Alcohol history?
Why: Alcoholic cirrhosis can cause an acquired bleeding disorder.
Questions your doctor may ask about related symptoms:
Sometimes, other symptoms may be present and may help your doctor analyse
your condition. These may include:
- Have you noticed bleeding from other areas?
Why: e.g. blood in urine, heavy menstrual periods, bleeding nose, bleeding gums, swollen painful joints, rectal bleeding? - suggests presence of a systemic bleeding defect.
- Tiredness, weight loss, fever or sweats?
Why: may suggest malignancy such as leukemia.
- Skin rash?
Why: may suggest lupus erythematosus which can cause an autoimmune thrombocytopenia.
- Widespread itchiness of skin?
Why: may suggest myeloproliferative cancers that can cause an acquired bleeding disorder or iron deficiency secondary to blood loss.
» Next page: Types of Bruising
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