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Hemolytic uremic syndrome — USMLE Step 2 CK MCQ

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ModerateInternal MedicineHemolytic uremic syndromeUSMLE Step 2 CK

A 50-year-old Asian American man comes to the hospital because of abdominal pain or gastrointestinal symptoms. History and focused examination are notable for bloody diarrhea followed by anemia, thrombocytopenia, and acute kidney injury. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most likely diagnosis?

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Correct answer: A — Hemolytic uremic syndrome

The vignette describes Hemolytic uremic syndrome, supported by bloody diarrhea followed by anemia, thrombocytopenia, and acute kidney injury. Hemolytic uremic syndrome is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: IDSA 2017 Infectious Diarrhea Guideline