Acute Kidney Injury USMLE Step 1 Practice Question
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 102/min, and a diffuse maculopapular rash. Laboratory studies reveal serum creatinine 2.8 mg/dL (baseline 0.9), sterile pyuria, and 8% eosinophiluria. Urinalysis shows no bacterial growth. Which of the following is the most likely diagnosis?
Answer choices
- AAcute glomerulonephritis
- BAcute pyelonephritis with sepsis
- CAcute interstitial nephritisCorrect answer
- DThrombotic thrombocytopenic purpura
- EDrug-induced systemic lupus erythematosus
- FSulfonamide crystal nephropathy from tubular precipitation of sulfamethoxazole
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