Acute Kidney Injury USMLE Step 1 Practice Questions
56 board-style USMLE Step 1 questions in Nephrology. Each question shows the correct answer; create a free account for the full explanation and adaptive practice.
- USMLE Step 1 · medium1. A 68-year-old man with a history of congestive heart failure presents with worsening dyspnea and lower extremity edema. He recently stopped taking his medications. Physical exam…
- USMLE Step 1 · medium2. A 54-year-old man presents for follow-up 3 weeks after emergency percutaneous coronary intervention for ST-elevation myocardial infarction. During hospitalization, he developed…
- USMLE Step 1 · medium3. A 67-year-old man with hypertension and type 2 diabetes presents with acute onset oliguria after undergoing coronary angiography for unstable angina. Serum creatinine increased…
- USMLE Step 1 · medium4. A 71-year-old man with a 15-year history of hypertension presents to the emergency department with a 2-day history of severe occipital headache, blurred vision, and nausea. His…
- USMLE Step 1 · hard5. A 42-year-old male construction worker is extricated from a collapsed building after being trapped under heavy rubble for 6 hours. He sustained severe crush injuries to both low…
- USMLE Step 1 · hard6. A 64-year-old man with chronic kidney disease (baseline creatinine 2.5 mg/dL) is started on lisinopril for hypertension. Two weeks later, his serum creatinine rises to 3.8 mg/dL…
- USMLE Step 1 · hard7. A 34-year-old woman with a 6-year history of systemic lupus erythematosus presents to the emergency department with dyspnea and bilateral ankle edema. Her medications include pr…
- USMLE Step 1 · easy8. A 55-year-old man with type 2 diabetes and hypertension develops acute kidney injury after 2 days of vomiting and diarrhea. Physical exam shows decreased skin turgor and orthost…
- USMLE Step 1 · medium9. A 52-year-old man with recent cardiac catheterization for acute coronary syndrome develops acute kidney injury the next morning. His creatinine rises from 1.0 to 2.8 mg/dL in 24…
- USMLE Step 1 · medium10. A 28-year-old woman on oral contraceptives presents 3 days after starting trimethoprim-sulfamethoxazole for a urinary tract infection. She has fever (38.5°C), BP 128/82 mmHg, HR…
- USMLE Step 1 · medium11. A 72-year-old woman admitted with community-acquired pneumonia receives gentamicin therapy. On hospital day 3, she develops oliguria with urine output of 800 mL/day. Vital signs…
- USMLE Step 1 · medium12. A 65-year-old man with hypertension and diabetes presents with acute onset oliguria and serum creatinine of 4.2 mg/dL (baseline 1.0 mg/dL). Urinalysis shows muddy brown casts. H…
- USMLE Step 1 · hard13. A 41-year-old man with HIV infection (CD4 count 45 cells/μL) is found unresponsive with seizures. Head CT shows mass lesions. He is started empirically on trimethoprim-sulfameth…
- USMLE Step 1 · easy14. A 3-year-old boy presents with 5 days of bloody diarrhea and now oliguria. Vital signs: BP 128/82 mmHg, HR 118/min, RR 24/min, Temp 37.2°C, SpO2 98% on room air. Serum creatinin…
- USMLE Step 1 · medium15. A 64-year-old woman admitted for acute pancreatitis develops acute kidney injury on hospital day 3. Urinalysis shows muddy brown casts and tubular epithelial cells. Creatinine i…
- USMLE Step 1 · hard16. A 56-year-old man with a 10-year history of type 2 diabetes and hypertension presents to the emergency department with progressive nausea, malaise, and dyspnea over 2 days. He d…
- USMLE Step 1 · hard17. A 28-year-old woman with a 3-month history of systemic lupus erythematosus presents to the emergency department with a 5-day history of malaise, dyspnea, and dark urine. Her tem…
- USMLE Step 1 · medium18. A 52-year-old man with a history of hypertension presents with a 3-day history of productive cough, fever, and dyspnea. Chest imaging confirms pneumonia. On admission, his blood…
- USMLE Step 1 · medium19. A 34-year-old woman with systemic lupus erythematosus presents with acute onset hematuria and flank pain. Vital signs: BP 152/96 mmHg, HR 98/min, RR 18/min, Temp 37.2°C, SpO2 98…
- USMLE Step 1 · medium20. A 68-year-old man with a 10-year history of type 2 diabetes mellitus and hypertension presents for routine follow-up. His baseline serum creatinine is 1.8 mg/dL (eGFR 38 mL/min/…
- USMLE Step 1 · medium21. A 45-year-old woman with no prior medical history presents to the emergency department 4 hours after a motor vehicle accident with crush injuries to both lower extremities. On e…
- USMLE Step 1 · medium22. A 72-year-old man with a 10-year history of hypertension and type 2 diabetes mellitus presents to the emergency department with acute dyspnea, confusion, and oliguria 2 days aft…
- USMLE Step 1 · medium23. A 58-year-old man undergoes elective abdominal aortic aneurysm repair. Postoperatively, he develops oliguria with BP 102/64 mmHg, HR 98/min, and serum creatinine 2.9 mg/dL (base…
- USMLE Step 1 · medium24. A 41-year-old man with a 6-month history of poorly controlled hypertension presents to the emergency department with severe frontal headache, dyspnea, and blurred vision that be…