Paediatric infections: haemolytic uraemic syndrome: practice question

A Pediatrics 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.

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Pediatrics · Paediatric infections: haemolytic uraemic syndrome

Sample item

A 3-year-old develops bloody diarrhoea after eating undercooked meat. Five days later he is pale, oliguric and has haemoglobin 7 g/dL with schistocytes, platelets 40,000 and a raised creatinine. Which statement about management is correct?

ASupportive care with fluid balance and dialysis if needed; antibiotics are avoidedBPlatelet transfusion should be given routinelyCEarly antibiotics reduce the risk of the syndromeDAntimotility agents should be given for diarrhoea

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

The answer and the reasoning

A. Supportive care with fluid balance and dialysis if needed; antibiotics are avoided

Shiga-toxin producing E. coli O157:H7 causes diarrhoea-associated haemolytic uraemic syndrome, with microangiopathic haemolysis, thrombocytopenia and renal failure. Treatment is supportive, including dialysis, and antibiotics and antimotility drugs may increase toxin release. Platelets are avoided unless bleeding.

Option by option

A. Supportive care with fluid balance and dialysis if needed; antibiotics are avoided (correct)
Correct. Supportive care and dialysis are the mainstay, and antibiotics are avoided.
B. Platelet transfusion should be given routinely
Platelet transfusion may add to microvascular thrombosis and is reserved for bleeding or procedures.
C. Early antibiotics reduce the risk of the syndrome
Antibiotics may raise the risk of HUS by increasing toxin release.
D. Antimotility agents should be given for diarrhoea
Antimotility drugs prolong toxin exposure and are avoided.

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.

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Supportive care with fluid balance and dialysis if needed; antibiotics are avoided. Shiga-toxin producing E.

Why is "Platelet transfusion should be given routinely" not the answer?

Platelet transfusion may add to microvascular thrombosis and is reserved for bleeding or procedures.

Why is "Early antibiotics reduce the risk of the syndrome" not the answer?

Antibiotics may raise the risk of HUS by increasing toxin release.

Why is "Antimotility agents should be given for diarrhoea" not the answer?

Antimotility drugs prolong toxin exposure and are avoided.

What concept does this question test?

It tests Paediatric infections: haemolytic uraemic syndrome in Pediatrics. coli O157:H7 causes diarrhoea-associated haemolytic uraemic syndrome, with microangiopathic haemolysis, thrombocytopenia and renal failure. Treatment is supportive, including dialysis, and antibiotics and antimotility drugs may increase toxin release. Platelets are avoided unless bleeding.

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 Paediatric infections: haemolytic uraemic syndrome?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics 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.