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Haemolytic uraemic syndrome — RACP Paediatrics MCQ

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HardNephrologyHaemolytic uraemic syndromeRACP Paediatrics

A 3-year-old with Shiga-toxin E. coli HUS is oliguric, hypertensive and 8% above pre-illness weight. Potassium is 6.2 mmol/L despite medical treatment. Which next plan is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Use oliguric fluid restriction and obtain urgent dialysis assessment

Explanation lettering: C = shown as A · A = shown as C · E = shown as D · D = shown as E

E is correct because oliguric HUS with overload and refractory hyperkalaemia requires tightly prescribed fluid and early dialysis planning. A worsens hypertension, pulmonary oedema and electrolyte risk. B is avoided because reduced bowel motility may worsen illness. C is not required in D. coli HUS and may increase toxin release. D uses platelet count rather than bleeding or a procedure; unnecessary platelet transfusion may add thrombotic substrate.

Reference: Perth Children’s Hospital, Haemolytic uraemic syndrome: https://pch.health.wa.gov.au/For-health-professionals/Emergency-Department-Guidelines/Haemolytic-Uraemic-Syndrome