All of the following are correct for causes of intrarenal acute kidney injury except:
Acute renal disease-acute glomerulonephritits
Exposure to nephrotoxic drugs, heavy metals, and organic solvents
Prolonged renal ischemia
Liver failure
The Correct Answer is D
A. Acute renal disease–acute glomerulonephritis: This leads to inflammation and damage of the glomerular basement membrane, impairing filtration and causing intrarenal injury. It often presents with hematuria, proteinuria, and hypertension.
B. Exposure to nephrotoxic drugs, heavy metals, and organic solvents: These substances damage renal tubules through direct toxicity or by causing crystal formation, leading to acute tubular necrosis. Common agents include aminoglycosides and contrast dyes.
C. Prolonged renal ischemia: Sustained low perfusion causes tubular cell death and sloughing, leading to obstruction and decreased GFR. It is often a progression from untreated prerenal AKI.
D. Liver failure: Liver dysfunction reduces renal perfusion and may cause hepatorenal syndrome, but this is classified as prerenal, not intrarenal, in origin. The kidneys are structurally intact but functionally impaired.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
A. Blood glucose levels in DKA are typically higher than in HHS: In fact, HHS usually presents with higher blood glucose levels than DKA—often exceeding 600 mg/dL, while DKA typically ranges from 250 to 600 mg/dL.
B. DKA involves significant ketosis and metabolic acidosis, while HHS typically does not: DKA is characterized by the breakdown of fats into ketones, leading to metabolic acidosis. HHS typically lacks significant ketosis because insulin levels, while low, are still sufficient to suppress ketogenesis.
C. DKA is more common in type 1 diabetes, while HHS is more common in type 2 diabetes: DKA usually occurs in individuals with type 1 diabetes due to absolute insulin deficiency. HHS is more often seen in type 2 diabetics who still produce some insulin but not enough to prevent severe hyperglycemia and dehydration.
D. None of the above: This choice is incorrect, as B, C, and E are valid differences between DKA and HHS.
E. HHS patients often have more severe dehydration than DKA patients: HHS leads to profound osmotic diuresis over a longer period, causing extreme dehydration. DKA progresses faster but with less total fluid loss compared to HHS.
Correct Answer is C
Explanation
A. Hemorrhage: Hemorrhage leads to significant blood loss, resulting in decreased blood volume and reduced renal perfusion, which is a common cause of prerenal acute kidney injury (AKI).
B. Cirrhosis: Cirrhosis can cause systemic vasodilation and reduced effective circulating volume, leading to decreased renal blood flow and prerenal failure due to impaired kidney perfusion.
C. Kidney disease: Kidney disease itself is an intrinsic (renal) cause of kidney failure, involving direct damage to the kidney tissue, rather than prerenal failure caused by decreased perfusion.
D. Narrowing of the blood vessels leading to the kidneys: Renal artery stenosis reduces blood flow to the kidneys, causing prerenal failure by impairing kidney perfusion despite adequate circulating volume.
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