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A 65-year-old male patient presents with sudden onset of oliguria and signs of dehydration His blood pressure is 90/60 mmHg, heart rate is 110 bpm and he has poor skin turgor. Laboratory results show elevated blood urea nitrogen (BUN and creatinine levels. Which of the following is the most likely cause of his acute kidney injury (AKI)?

A.

Hypovolemia leading to decreased renal perfusion

B.

Acute tubular necrosis

C.

Urinary tract obstruction

D.

Chronic kidney disease

Answer and Explanation

The Correct Answer is A

A. Hypovolemia leading to decreased renal perfusion. Hypovolemia from dehydration and low blood pressure reduces blood flow to the kidneys, resulting in pre-renal AKI, characterized by elevated BUN and creatinine.

B. Acute tubular necrosis. Acute tubular necrosis may cause AKI but is often due to prolonged hypoperfusion, nephrotoxic drugs, or ischemia, not the immediate presentation seen here.

C. Urinary tract obstruction. A urinary tract obstruction leads to post-renal AKI, often with symptoms like flank pain or difficulty urinating, not dehydration and low blood pressure.

D. Chronic kidney disease. Chronic kidney disease is a long-term condition and would not cause the acute symptoms or sudden onset of AKI as seen in this patient.


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Related Questions

Correct Answer is D

Explanation

A. Peripheral Artery Disease (PAD). PAD is a chronic condition related to reduced blood flow in peripheral arteries. It is not directly associated with MI complications.

B. Gastroesophageal Reflux Disease (GERD). GERD involves acid reflux and is not related to post-MI complications.

C. Hypertension. While hypertension is a risk factor for MI, it does not directly explain the symptoms of shortness of breath and irregular heartbeats following an MI.

D. Heart Failure. Heart failure is a common post-MI complication, especially if a significant portion of heart muscle is damaged. Symptoms of shortness of breath and irregular heartbeats could indicate left-sided heart failure, where fluid backs up into the lungs, or right-sided failure, which can lead to systemic congestion.

Correct Answer is D

Explanation

A. Frequent urination. Frequent urination is not typically associated with Crohn’s disease, which primarily affects the gastrointestinal system.

B. Jaundice. Jaundice is related to liver or biliary system issues and is not a common symptom of Crohn’s disease.

C. Joint pain. While Crohn’s disease may be associated with extraintestinal symptoms, joint pain is not as common as gastrointestinal symptoms during an exacerbation.

D. Abdominal pain and cramping. Abdominal pain and cramping are common symptoms of Crohn’s disease, especially during flare-ups, due to inflammation in the digestive tract.

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