55.

(A) The child most likely has hemolytic-uremic

syndrome. This illness is most common in children

under 2 years old. They present with a prodromal

illness, bloody diarrhea, and then a
sudden onset of lethargy and pallor when the
hemolytic anemia occurs. Coincident with this is
the development of acute renal failure, often with
low urine output. E. coli 0157:H7 is the most
common organism in the United States. Group A
Streptococci are associated with poststreptococcal
acute glomerulonephritis. Thrombocytopenia
and anemia are not seen in this disease. (Rudolph
and Rudolph, 2003, pp. 15861587)

56. (B) Varicella vaccine is a live vaccine. All others

are killed vaccines. Diphtheria and tetanus are