A 4-year-old with hemolytic uremic syndrome (HUS) has the following labs: Hemoglobin: 8.2 g/dL (Normal range: 11-14g/dL) Platelets 82,000/mm³ (Normal range: 150,000-400,000/mm³) Creatinine: 3.1 mg/dL (Normal range: 0.2-0.7 mg/dL) Which clinical manifestations are directly explained by the destruction of red blood cells and platelet consumption? Select all that apply.

A. Petechiae and purpura: Low platelet count from platelet consumption in HUS impairs clotting, leading to bleeding into the skin and mucous membranes. This presents as petechiae and purpura. B. Fatigue: Destruction of red blood cells causes anemia, which reduces oxygen delivery to tissues. This leads to fatigue, weakness, and reduced activity tolerance. C. Pallor: Anemia from hemolysis lowers hemoglobin levels, reducing tissue perfusion and oxygenation. Clinically, this presents as pallor of the skin and mucous membranes. D. Hypertension: Hypertension in HUS is related to renal impairment and fluid overload, not directly to RBC destruction or platelet consumption. It reflects kidney injury rather than hematologic changes. E. Hematuria: Hematuria results from renal damage caused by microthrombi in glomerular capillaries. While part of HUS, it is not directly due to RBC destruction or platelet consumption but rather to kidney involvement.