HY USMLE Q #1021 – Hematology

A 9-year-old boy is brought to emergency for a 5-day history of bloody diarrhea. He has had generalized fatigue for 3 days. Temperature is 98.6 F. Examination shows scleral icterus and pallor. Laboratory studies show:

Hemoglobin                                                                      7 g/dL
MCV                                                                                      85 fL
Leukocytes                                                                        19,000/μL
Platelets                                                                              60,000/μL
Coombs test                                                                     Negative

Which of the following is the most likely explanation for these findings?

  Cold autoimmune hemolytic anemia
  Glucose-6-phosphate dehydrogenase deficiency
  Hemolytic uremic syndrome
  Shigellosis
  Thrombotic thrombocytopenic purpura

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