Ans. is 'c' i.e., Idiopathic thrombocytopenic purpura Petechial spots without hepatosplenomegaly in a 5 year old boy suggest the diagnosis of ITP. About other options Acute leukemia o Acute leukemia will give features of involvement of all the three lineages i.e. anemia (erythrocyte involvement) fever (due to neutrophil involvement) bleeding (due to platelet involvement) Moreover splenomegaly and lymphadenopathy are usually present in Acute leukemias. Aplastic anemia o Aplastic anemia too will present with features, characteristic of involvement of all the three lineages i.e. severe anemia, fever bleeding.