Answer: D. All of the above

Explanation: Splenectomy is the most effective form of therapy and is indicated for patients who do not respond to corticosteroids, for those who relapse after an initial remission on steroids, and for steroid-dependent patients. Corticosteroid therapy is not necessary in the immediate preoperative period unless bleeding is severe or the patient was receiving steroids before the operation.
Corticosteroids are indicated in patients with moderate to severe purpura of short duration.
Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds.Tintinalli’s Emergency

Reference: Santen SA, Hemphill RR. Chapter 228. Acquired Bleeding Disorders. In:Tintinalli JE, Medicine: A Comprehensive Study Guide, 7e.​

Answer: C. 4-8 years

Explanation: Henoch-Schonlein purpura (HSP) is the most common form of systemic vasculitis in children, usually present at 4-8 years of age and usually affects the extensor surface of the arms, legs, and buttocks, but can involve any site. This disorder is characterized by small vessel vasculitis of the skin, gastrointestinal tract, and kidneys. Patients will at times have palpable purpura of the skin, joint swelling and pain, and colicky abdominal pain. Gastrointestinal bleeding may be secondary to submucosal hemorrhage. Dapsone (100 mg/d) may be effective in cases of HSP.

Reference: Chapter 39. Henoch-Schönlein Purpura. In: Imboden JB, Hellmann DB, Stone JH. eds. CURRENT Rheumatology Diagnosis & Treatment, 3e.