<prompt> A 4 year old child presented with decreased urine output for last 20 hours petechial spots over the body. There was a history of diarrhea 2 weeks prior to this. Blood investigations revealed a Hb level of 7 gdl, TLC 11,800mm3, Platelet count of 35,000mm3. His peripheral smear fndings are shown below What is the diagnosis?MalariaIdiopathic thrombocytopenic purpuraHenoch Schonlein PurpuraHemolytic uremic syndrome  <response>: Peripheral smear showing schistocytes in a child with oliguria, thrombocytopenia, anemia a history of recent diarrhea suggest a diagnosis of Hemolytic uremic syndrome HUS Shiga-toxin producing E. coli STEC and Shigella dysentriae type 1 are usual causes of HUS in children. Hemolytic-uremic syndrome HUS is a common cause of community acquired acute kidney injury in young children characterised by a triad of Microangiopathic Hemolytic anemia Thrombocytopenia Renal insufficiency Laboratory findings: low hemoglobin level, decreased platelet count, hypoalbuminemia, and hemolysis on peripheral smear burr cells, helmet cells, schistocytes Urinalysis reveals hematuria and proteinuria. A marked reduction of renal function leads to oliguria and rising levels of blood urea nitrogen BUN and creatinine Other options in the question: Malaria- Presents with fever, chills rigors, pain in limbs. Peripheral Blood Film shows malarial parasite. ITP - comes with ho fever, sudden appearance of bruises mucosal bledding Acute tubular necrosis- oliguria, edema, hypeension. 