This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Bleeding disorders, Subject name: Pediatrics
Which of the following is generally not seen in idiopathic thrombocytopenic purpura (ITP)? 
Select and explain. 
A. More common in females, B. Petechiae, ecchymosis and bleeding, C. Palpable splenomegaly, D. Increased megakaryocytes in bone marrow
C: Palpable splenomegaly
Answer: C: Palpable splenomegaly 
Explanation: Discussing options one by one: a. Chronic ITP occurs most commonly in adult women, younger than age 40 years (Female: Male = 4:1) b. Cutaneous bleeding occurs in the form of pinpoint hemorrhages, petechiae or ecchymoses. Often there will be history of easy bruising, nose bleeds, bleeding from gums and hemorrhage in soft tissues from relatively minor trauma. c. Despite the increased destruction of platelets in spleen, spleen size usually remains normal in ITP. d. Bone marrow reveals a modestly increased number of megakaryocytes.