Nephrology: haemolytic uraemic syndrome: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Medicine · Nephrology: haemolytic uraemic syndrome

Sample item

A child develops bloody diarrhoea followed after 5 days by pallor, oliguria, haemoglobin 7 g/dL with schistocytes and platelet count of 40,000. What is the diagnosis and key management point?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Shiga-toxin HUS; supportive care and avoid antibiotics

Diarrhoea-associated HUS from Shiga toxin producing E. coli gives the triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury. Treatment is supportive with fluids and dialysis if needed, and antibiotics and antimotility drugs may increase toxin release. Coagulation tests are normal, unlike DIC.

Option by option

  • A. ITP; high-dose steroids

    ITP lacks haemolysis and renal failure.

  • B. DIC; heparin

    DIC has prolonged clotting tests and heparin is not indicated.

  • C. TTP; plasma exchange only

    TTP has neurological features and ADAMTS13 deficiency, and diarrhoea-associated HUS in children does not require exchange.

  • D. Shiga-toxin HUS; supportive care and avoid antibiotics (correct)

    Correct. Supportive care and avoiding antibiotics apply.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is D, Shiga-toxin HUS; supportive care and avoid antibiotics. Diarrhoea-associated HUS from Shiga toxin producing E.

Why is "ITP; high-dose steroids" not the answer?

ITP lacks haemolysis and renal failure.

Why is "DIC; heparin" not the answer?

DIC has prolonged clotting tests and heparin is not indicated.

Why is "TTP; plasma exchange only" not the answer?

TTP has neurological features and ADAMTS13 deficiency, and diarrhoea-associated HUS in children does not require exchange.

What concept does this question test?

It tests Nephrology: haemolytic uraemic syndrome in General Medicine. coli gives the triad of microangiopathic haemolytic anaemia, thrombocytopenia and acute kidney injury. Treatment is supportive with fluids and dialysis if needed, and antibiotics and antimotility drugs may increase toxin release. Coagulation tests are normal, unlike DIC.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nephrology: haemolytic uraemic syndrome?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.