Acute Kidney Injury USMLE Step 1 Practice Question
A 70-year-old man with acute intracranial hemorrhage receives intravenous mannitol. Within hours, he develops worsening dyspnea and bibasilar crackles. Vital signs show BP 168/92 mmHg, HR 108/min, RR 24/min, SpO2 88% on room air. Serum creatinine is 3.2 mg/dL (baseline 1.1). Chest X-ray reveals pulmonary edema. He denies chest pain. Which preexisting condition most likely increased the risk of this osmotic nephropathy complication?
Answer choices
- AChronic gout
- BPrimary hyperparathyroidism
- CChronic hepatitis C infection
- DType 1 diabetes mellitus
- ECongestive heart failureCorrect answer
- FChronic kidney disease impairing mannitol excretion
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