MICA

Haematology

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← Clinical semiology

4 sheets

Numerous separate pinpoint red-purple spots on a lower leg, with a few accompanying crusts.

Skin, mucosa & appendages

Petechiae

Pinpoint haemorrhagic macules; distribution and fever determine urgency.

Size: Pinpoint, usually ≤2 mm
Elevation: Flat macules
Pressure: Do not blanch
Context: Associated fever and bleeding

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Skin, mucosa & appendages

Purpura

Haemorrhagic spots that persist under pressure; elevation and systemic findings guide assessment.

Mechanism: Blood extravasation
Blanching test: No blanching
Elevation: Flat or palpable
Direction: Platelets, coagulation, vessels

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Skin, mucosa & appendages

Koilonychia

Spoon-shaped nail plate concavity whose cause cannot be inferred from shape alone.

Shape: Concave, spoon-shaped
Plate: Thin or brittle
Association: Possible iron deficiency
Specificity: No single cause

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Original MICA educational diagram

MAS: recognise a concerning trajectory

The diagram emphasises the clinical and laboratory trajectory rather than one isolated threshold. It shows no calculated probability or fictitious score.

Document: Original educational diagram
Scope: No real examination simulated
Takeaway: Absence of haemophagocytosis does not exclude MAS; severe disease should not wait for every investigation.

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