Haemolytic Uraemic Syndrome (hus) In Children

19 Questions  I  By Mogundel
This quiz is based on a comprehensive overview of the existing literature on the epidemiology, etiology, pathogenesis, clinical presentation, diagnosis and management of HUS.   It highlights the ongoing controversy regarding the role of antibiotics during the acute enteric phase of the classical HUS and the challenges involved in the management of the atypical diseases. .?

  
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1.  Which of the following identifiable risk factors do not suggest vulnerability for developing HUS?
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2.  What proportion of children infected with enterohemorrhagic Escherichia coli (STEC) O157:H7 develops HUS?
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3.  What proportion of children with HUS requires renal replacement therapy (dialysis) in the acute phase?
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4.  What is the role of antibiotics during the acute enteric phase of the STEC infection?
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5.  What is the mainstay of management of children with HUS?
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6.  Non-O157 E. coli may account for up to 20%-50% of all STEC infections?
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7.  HUS can also be caused by Shigellosis, Streptococcus pneumoniae, Clostridium difficile, Salmonella, Yersinia, Campylobacter species, varicella, echovirus, coxsackie A and B and human immunodeficiency virus (HIV)?
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8.  Approximately 5%-10% of all HUS cases have an "atypical" or recurrent course?
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9.  Causes for aHUS include complement disorders, disorders interfering with the degradation of von Willebrand factor (VWF), the cobalamin metabolism, pregnancy – (HELLP syndrome); drugs such as many chemotherapeutic agents, autoimmune and other disorders?
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B.
10.  A small group of aHUS in post bone marrow transplantation period may be caused by immunosuppressive drugs including cyclosporine, or following exposure to herbicides or pesticides and severe scorpion envenomation?
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B.
11.  Factors associated with good outcome of renal transplant in patients with non-Shiga toxin-associated HUS (non-Stx-HUS) include:
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12.  What is the clinical significance of HUS caused by pathogens other than STEC (including S pneumoniae and HIV)?
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13.  How can you describe the most characteristic pathologic processes in HUS?
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14.  What is the case fatality rate of HUS?        
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15.  Which of the following statements are true regarding Complications of hus?
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16.  Which of the following are not the typical laboratory findings in HUS?
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17.  Which of the following does not represent the main preventive measures and future prospects in the management of huS?
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18.  Characteristics of atypical HUS include:
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19.  Describe some specific clinical prognostic factors for patients with HUS.
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