The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 4-year-old girl is brought to the physician because of pallor and rash for 2 days. She had a 4-day history of diarrhea and vomiting that subsided two days ago. One month ago, she had a 3-day episode of high fever, followed by a rash with bright red discoloration over her cheeks for two days before subsiding without treatment. Her vaccinations are up-to-date. She appears pale and irritable. Her vital signs are within normal limits. Examination shows petechiae on her trunk and extremities. Abdominal examination shows diffuse abdominal tenderness with hyperactive bowel sounds. The remainder of the exam shows no abnormalities. Laboratory studies show: Hemoglobin 8 g/dL Mean corpuscular volume 82 fL Leukocyte count 17,000/mm3 Platelet count 49,000/mm3 Prothrombin time 12 seconds Partial thromboplastin time 34 seconds Serum Urea nitrogen 42 mg/dL Creatinine 1.4 mg/dL Bilirubin Total 3 mg/dL Indirect 2.8 mg/dL Lactate dehydrogenase 300 U/L Urine Blood 2+ Protein 2+ A peripheral blood smear shows schistocytes. Which of the following is the most likely underlying cause of these findings?"   (A) Escherichia coli infection   (B) Disseminated intravascular coagulation   (C) Immune thrombocytopenic purpura   (D) Thrombotic thrombocytopenic purpura
['(A) Escherichia coli infection <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Escherichia coli infection \n (B) Disseminated intravascular coagulation \n (C) Immune thrombocytopenic purpura \n (D) Thrombotic thrombocytopenic purpura <> possible answers', '  A 4-year-old girl is brought to the physician because of pallor and rash for 2 days. She had a 4-day history of diarrhea and vomiting that subsided two days ago. One month ago, she had a 3-day episode of high fever, followed by a rash with bright red discoloration over her cheeks for two days before subsiding without treatment. Her vaccinations are up-to-date. She appears pale and irritable. Her vital signs are within normal limits. Examination shows petechiae on her trunk and extremities. Abdominal examination shows diffuse abdominal tenderness with hyperactive bowel sounds. The remainder of the exam shows no abnormalities. Laboratory studies show:\nHemoglobin 8 g/dL\nMean corpuscular volume 82 fL\nLeukocyte count 17,000/mm3\nPlatelet count 49,000/mm3\nProthrombin time 12 seconds\nPartial thromboplastin time 34 seconds\nSerum\nUrea nitrogen 42 mg/dL\nCreatinine 1.4 mg/dL\nBilirubin\nTotal 3 mg/dL\nIndirect 2.8 mg/dL\nLactate dehydrogenase 300 U/L\nUrine\nBlood 2+\nProtein 2+\nA peripheral blood smear shows schistocytes. Which of the following is the most likely underlying cause of these findings?" <> context@']