MLA Domain 5 · Presentation

Epistaxis

6 conditions in Finalist present this way. Work down the list and ask what would separate each one from the next — that discriminator is the exam question.

classic presentation · 2

Epistaxis

Haemodynamic compromise, posterior bleed not controlled by packing, anticoagulated/bleeding disorder → resuscitate + urg

Vasculitides

Pulmonary-renal syndrome (haemoptysis + AKI/active sediment) → rapidly progressive glomerulonephritis → emergency immuno

recognised feature · 4

Coagulation disorders (haemophilia & VWD)

Intracranial or significant bleeding in haemophilia → urgent factor replacement

Immune thrombocytopenia (ITP)

Significant mucosal/GI bleeding; suspected intracranial bleed (severe headache/neuro signs) — rare but serious

Nasopharyngeal carcinoma

Any unilateral adult glue ear, a persistent neck node, or cranial nerve palsies → urgent ENT (nasendoscopy + biopsy)

Thrombocytopenia & ITP

Thrombocytopenia + schistocytes (microangiopathy — TTP/HUS/DIC) → emergency; in TTP do NOT give platelets