Acute Kidney Injury USMLE Step 1 Practice Question
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-sulfamethoxazole for presumed Pneumocystis jirovecii prophylaxis. After 5 days, creatinine rises from 1.0 to 2.4 mg/dL, potassium is 6.2 mEq/L, and urinalysis shows pyuria and eosinophils. Which of the following is the most likely diagnosis?
Answer choices
- AAcute tubular necrosis from volume depletion
- BOpportunistic infection of the kidney from CMV
- CAcute interstitial nephritis from trimethoprim-sulfamethoxazoleCorrect answer
- DTrimethoprim-induced hyperkalemia with prerenal azotemia
- EHIV-associated nephropathy with collapsing focal segmental glomerulosclerosis
- FAcute glomerulonephritis from immune complex deposition secondary to HIV infection
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