Acute Kidney Injury USMLE Step 1 Practice Question
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 is 3.1 mg/dL (baseline 0.9), urine osmolality is 350 mOsm/kg, and fractional excretion of sodium is 2.8%. Which of the following is the most likely pathophysiology?
Answer choices
- APrerenal azotemia from decreased effective circulating volume
- BAcute interstitial nephritis from prophylactic antibiotics
- CPostrenal obstruction from pancreatic duct stricture
- DAcute tubular necrosis from rhabdomyolysis and hypovolemiaCorrect answer
- EAcute glomerulonephritis from immune complex deposition
- FHepatorenal syndrome from acute liver dysfunction secondary to pancreatitis
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