The most common cause of prerenal acute kidney injury (AKI) is:

Choice A reason: Rapid mood swings are characteristic of bipolar disorder, not OCD. OCD involves intrusive thoughts and compulsive behaviors, like Marty’s hand washing, so this is incorrect for OCD’s primary feature.

Choice B reason: Social withdrawal is more typical of depression or schizophrenia, not OCD. Marty’s persistent thoughts and rituals define OCD, making this incorrect for the disorder’s main characteristic.

Choice C reason: OCD is defined by persistent, unwanted thoughts (obsessions) and repetitive behaviors (compulsions), as seen in Marty’s germ fears and hand washing. This is the correct primary characteristic of OCD.

Choice D reason: Hallucinations and delusions are associated with psychotic disorders, not OCD. Marty’s intrusive thoughts and rituals are classic OCD symptoms, so this is incorrect for the primary feature.

Choice A reason: Yellowing of the sclera (icterus) is expected with high bilirubin in cirrhosis, as impaired liver function causes bilirubin accumulation. Conjugated bilirubin deposits in the sclera, visible early due to its vascularity, making this a correct clinical finding.

Choice B reason: Dark brown urine results from excess conjugated bilirubin excreted by the kidneys in cirrhosis. High bilirubin levels overwhelm liver clearance, leading to bilirubinuria, which darkens urine, making this a correct and common finding in this condition.

Choice C reason: Frothy light-colored urine is not associated with high bilirubin. Light urine suggests dilute urine or low bilirubin excretion, opposite to the dark urine seen in cirrhosis, making this an incorrect finding for this patient’s condition.

Choice D reason: Jaundice of the skin occurs with elevated bilirubin in cirrhosis, as bilirubin deposits in tissues. This yellowish discoloration is a hallmark of liver dysfunction, reflecting impaired bilirubin metabolism, making this a correct clinical manifestation.

Choice E reason: Bluish mucous membranes suggest cyanosis from hypoxemia, not related to high bilirubin. Cirrhosis causes jaundice, not oxygenation issues, unless complicated by other conditions, making this an incorrect finding for this patient.