A 5-year-old boy is brought to the physician for evaluation of pallor and increasing lethargy for 3 days. Six days ago, he experienced abdominal pain, vomiting, and bloody diarrhea that have since resolved. The day before the onset of symptoms, the patient swam in a lake and ate hamburgers at a family picnic. His temperature is 38.8°C (101.8°F), pulse is 128/min, respirations are 30/min, and blood pressure is 96/60 mm Hg. Examination shows pale conjunctivae and scleral icterus. Physical examination shows pallor but is otherwise normal. He has no peripheral edema or rashes. Laboratory evaluation shows anemia, thrombocytopenia, and elevated blood urea nitrogen and serum creatinine. Which of the following findings is most likely to be seen in this patient?

Question

A 5-year-old boy is brought to the physician for evaluation of pallor and increasing lethargy for 3 days. Six days ago, he experienced abdominal pain, vomiting, and bloody diarrhea that have since resolved. The day before the onset of symptoms, the patient swam in a lake and ate hamburgers at a family picnic.  His temperature is 38.8°C (101.8°F), pulse is 128/min, respirations are 30/min, and blood pressure is 96/60 mm Hg. Examination shows pale conjunctivae and scleral icterus. Physical examination shows pallor but is otherwise normal.  He has no peripheral edema or rashes. Laboratory evaluation shows anemia, thrombocytopenia, and elevated blood urea nitrogen and serum creatinine.  Which of the following findings is most likely to be seen in this patient?

Quizplus · Accepted Answer

Eductional Objective: Hemolytic uremic syndrome (HUS) manifests with acute kidney injury, microangiopathic hemolytic anemia, and thrombocytopenia.  Characteristic laboratory abnormalities include decreased hemoglobin and platelet count and increased bleeding time, lactate dehydrogenase, bilirubin, blood urea nitrogen, and creatinine.

A 5-Year-Old Boy Is Brought to the Physician for Evaluation