Thrombotic microangiopathy Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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A 4-year-old boy presents to the emergency department for evaluation of bloody diarrhea, fatigue, and epistaxis. Parents report the patient developed watery diarrhea, fevers, and chills three days ago; however, today he had bloody diarrhea and developed epistaxis. The family recently visited friends at their farm, where they sampled a variety of fruits, vegetables, and cheeses. The patient was born full term and is otherwise healthy. Vaccinations are up-to-date. Temperature is 39.4°C (103°F), pulse is 132/min, respiratory rate is 22/min, blood pressure is 86/64 mm Hg, and oxygen saturation is 99% on room air. On physical examination, the patient appears pale, with poor skin turgor. Faint mucosal hemorrhage is noted on intraoral examination. There is blood in the nares bilaterally. Abdominal examination reveals generalized tenderness to palpation without rebound or guarding. Cardiopulmonary and neurologic examinations are unremarkable. Scant purpuras are noted over the chest, back, and legs. Results of blood work are shown below. Gram stain from blood cultures is negative. Peripheral blood smear shows schistocytes. Given the most likely diagnosis, which of the following would not be recommended for this patient? 

 CBC     Result   
 Hemoglobin     6.7 g/dL    
 Hematocrit     19 %    
 Leukocyte count     18,100 /mm3    
 Platelet count     12,000/mm3    

 BMP     Result   
 Serum chemistry    
 Sodium      132 mEq/L    
 Potassium      3.2 mEq/L    
 Chloride      95 mEq/L    
 Creatinine      3.1 mg/dL    
 Albumin      3.2 g/dL    
 BUN/Cr     > 20    

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